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Work Activity Work Or.der <br />ISSUed By HLJ HUSBY, LANCE J. <br />Issued DepartmentPw PUBLICWORKS <br />Date Issued �ziz3no�5 <br />Fcrd ao� Accounts Prcaram <br />Program UT3473 9 � <br />Td�e CONVERT 751NCH 7724 HOYT AVE UT3473�9�3 <br />Work Order No 20152748 Pro�ect <br />S,atus ivz�rzois Time oeoz Onginal WC� <br />_>>-- <br />_,_._��_, �. �. <br />Funct�on Achv��y <br />Actiwty Type CORREC7IVE 61AMTENANCf S:2t115 CL <br />Bdling <br />Customer Information <br />Customer Name Customer ld <br />Address Streel <br />Aoartment No C�'•> <br />State Z�P <br />Subd,vision Change Map Yl� <br />Phone No � 1 • F�t <br />Second Phone ( 1 - Exl -- <br />E-Mad Address <br />Problem Information <br />Address 33Yq Street HOYT AVE <br />From Cross Street � <br />To Cross Street <br />City Zip <br />Subdrvlsion Map Book Ivtap Re(erencc <br />Problem WA7ER WATER <br />Sub Problem OTHER OTHER <br />Requ 'ed By Date Reques;ed <br />Agercy Related Request <br />IniUated From . <br />UtdCy Locate (USA) No Called Date Expiralion Date <br />Assignment Information <br />Dept Pr�onty Lshmated Hours <br />Crew <br />Contractor <br />Assigned To <br />Ass�gned By <br />Assigned Date ___ __ To Be Comp Date <br />Scheduled D�le Scheduled T�me _ <br />Route Route Sequznce <br />Comments <br />Action Taken CONVERT .751NCH CURBSTOP T0.751NCH SETTER YlITH METER PND BOX FLAi TO �."ETER <br />• PROGRAR7. <br />Recommended Action <br />Approved By WpL WEAVER. DEAN L <br />Slart Date � � Time <br />_ . -- — <br />Completed By <br />Job Cost Information(Y/N) <br />Date Completed i2izeizo�s Permit No <br />Time , Follow Up� <br />