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Work Activity Work Order �°�r � <br />izi:e/�oi� �:�i <br />ISSUEd By CSG . CAVANAH, SHANE G. <br />Issued Department aw PUBLIC WORKS <br />Da;e Issued ennzou <br />Fund aot Account s Program T�o Funcuon i�g Actiwiy 6�s <br />Program <br />TIII@ REPtACE t INCH t511 B GRAND AVE 710179675 <br />Work Order No Z��520�2 PfOf2Ci ACUvity Type CORRECTIVE MAWTEYANC[ Si8IU5 CL <br />Status 9nn2o�s Time >> 5< Original WO 20�5�9�5 BBErn� __ _. __ <br />Customer Information <br />Customer Name Custumer ld <br />Address Street <br />Apartment Nc City <br />State Z�P <br />Subdivision Change Map Y!N <br />Phone No ( 1 • Ext <br />SecondPhone ( 1 • Ext ---- - <br />E-Mail Address _ ___ _ . _ _ _ <br />Problem Information <br />Address Streel <br />Frem Cross Street <br />To Cross Street <br />City Z'p <br />Subdrvision Niap Book Map Ref=_rer.ce <br />Problern <br />Sub Problem <br />Requested By <br />Agency <br />Initiated From <br />Utility Locate (USA) No Called Date Expira6on Date <br />Assignment Iniormation <br />Date Requested <br />Related Request <br />Dep� Prionty Eslimated Hours <br />Crcw <br />Contractor <br />Assigned To <br />Ass�gned By <br />Assigned Date _ To Be Comp Date <br />Scheduled Date ___ .____ Scheduted Time <br />Route Route Sequence <br />Comments <br />Action Taken RENEWED 1" POLY AND CONNECTED TO NEW 8" MAIN WITH NEW SETTER AN� BOX. <br />Recommended Action <br />Approved By RJP RAFELYEA,JASON P <br />Start Date i � Time <br />Comple:ted By __ <br />Job Cost InformaUon(YIN) <br />Date Completed snn�o�s <br />Time Follow Up9 <br />Permit No <br />