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Work Activity Work Order °a9�� 1 <br /> iol�i'-oia ii : i� <br /> ISSUBd BY SJT2 SPOONER,JAMES T. <br /> Issued Departmentaw PUBLICWORKS <br /> Date Issued enoizo�a <br /> Fund ao� Account s Program Function Activity <br /> Program UT3473 s 3 <br /> TIIIB CONVERT 751NCH 1607 GRANDAVE UT3473�5�3 <br /> Work Order P�o Z��4289� �fOJEC1 Activity Type CORRECTIVE MAINTENANCE S18fUS CL <br /> Status enoizoia Time o�o� Original WO Billing ___ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State ZiP <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext <br /> Second Phone ( ) - Ext — --- ---- <br /> E-Maii Address <br /> Problem Information <br /> Address 160� Street GRAND AVE <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 /> U!i6ty Locate(USA) No Called Date Expiralion Date <br /> Assignment Information <br /> Dept Pnonty Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date __ �:; �:. ,. <br /> ��'p`�� R`'��" ��;�`�!',�9' <br /> Scheduted Date Scheduled Time _ � = <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.75 INCH CURBSTOP TO.75 INCH SETTER WITH METER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By HLJ HUS�Y.LANCE J. JOb COSI IflfOff118fi0f1(Y/N) <br /> Start Date i � Time Date Completed enuzotq ___ Permit No _ _ <br /> Completed By Time Follow Up? <br />