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Work Activity Work Order Pa9e 1 <br /> e�s�zoiz is:as <br /> ISSUBd By SJT2 SF'OONER,JAMES T. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date issued s�ze�zoiz <br /> Fund ao� Account s Program �to Function »y Activiry s�s <br /> Program <br /> TI�IO REPAIR.75 1NCH 2321 JACKSON AVE 710N0675 <br /> WOfk Ofd2f NO 20121049 PfOJ�'_C� Activiry Type CORRECTIVE h�AINT'cNANCE ?18tt15 CL <br /> StaWs s�2sizoiz Time os:os Ori�inal WO Billing <br /> Customer Inforrnation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�E� Change Map YIN <br /> Subdivision <br /> Phone No ( � • Ext _ _ <br /> Second Phone l 1 - F_xt <br /> E-Mail Address <br /> Problem Information <br /> Address 23y� Street �qCKSONAVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate(USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date _ Scheduled Time _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPLACE.75 INCH CURBSTOP WlTti.75 INCH SETTER,JUMPER,BOX AND LOCK OFF.DEL <br /> ACC. <br /> Recommended Action <br /> Approved By H�J Husev,u+Nce:�. Job Cost information(YIN) <br /> S'art Date I � Time Date Completed 612912012 Permit No <br /> Completed By Time Foilow Up? <br />