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Work Activity Work Order <br />ISSlled Bj� HLJ HU58Y, LANCE J. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 1i5i2076 <br />Fund aot Accounts Program <br />Program uraa73 s � <br />Titl2 CONVERT 751NCH 3275 HOV7 AVE UT3<73-9-3 <br />Vdork Order No 20160099 Pro�ect <br />Status "�'zcic T�me �o:o Or�r,�nal VJ0 <br />FurcLon :+c:i�ity <br />AChvih� TypE CORRECTIVc �d:.IKTEN�NCE Sta:uS CL <br />Billing <br />Customer Information <br />Customer Na2e Custome� Id <br />Address Street <br />Apartment No ��tY <br />Sta'.e Z�P <br />Subd�v�sion Change Map YrN <br />Phone No � 1 - Ext <br />Second Phone c 1- Ext - <br />E-R4ail Address <br />Problem Information <br />Address 3y�5 Street yOYTAVE <br />From Cross Street <br />To Cross Streel <br />City Zip . <br />Subdivision tutap Book Map Re`erence <br />Problem WATER WATER <br />Sub Problem OTN.ER OTHER <br />Requesled By Date Requested <br />Agency Related Request <br />ImUated From <br />Utdiry Locate (USA) IJo Called Date Expiralicn Dale <br />Assignment In(ormatian <br />�eP� Pnonty Eshrnated h-lours <br />Cre�v <br />Contracror <br />Assi ned To <br />9 �r� @ r�, ,r <br />Assigned By �� + "� �� �„'pp <br />d D t To Be Comp Date �'�' ��� <br />Assgne a e <br />Scheduled Dale _ _ Scheduled Time _ <br />Route Roule Sequence <br />Comments <br />Action Taken CONVERT ]51NCH CURBSTOP TO ]S INCH SETTER WlTH METER AND BO% FLAT TO METER <br />PROGRAM. <br />Recommended Aclion <br />Approved By WDL WEAVEH [JEAN l <br />Start Date i i Time <br />Completed C3y <br />Job Costlnformation(Y/N) <br />-- _— - — <br />Date Completed veno�6 _ Permit No <br />Time Follow Up� <br />