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Work Activity Work Order <br />Page 1 <br />iz/ze/zoii is:zs <br />ISSU@d By SJT2 SPOONER, JAMES T. <br />Issued Department aw PUBLIC WORKS <br />Date Issued 1215I2011 <br />Fund ao� Account 5 Program 7to Function tte Activity e�s <br />Program <br />Title REPAIR .� S INCH 4816 HARBOR LN 710119675 <br />WO�k Otd¢C NO 20112577 PfOjBCt Activity Type CORRECTIVE MAINTENANCE StBtUS CL <br />Status izi5�zot� Time is:3o__Original WO_ Billing ____ _ <br />Customer Information <br />Customer Name Customer ld <br />Address Street <br />Apartment No City <br />State Z�P <br />Subdivision Change Map YIN <br />Phone No ( ) - Ext <br />Second Phone l ) • Ext — <br />E-Mail Address <br />Problem Information <br />Address 4816 Street HARBOR LN <br />From Cross Street <br />To Cross Street <br />Ciry Z�P <br />Subdivision Map Book <br />Problem WATER WATER <br />Sub Problem OTHER OTHER <br />Requested By <br />Agency <br />Initiated From <br />Map Reference <br />Utility Locate (USA) No Cailed Date Expiration Date <br />Assignment information <br />Dept Priority <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 WITH .75 INCH SETTER, JUMPER AND BOX. <br />Recommended Action <br />Approved By SDG SMITH, DAVID G. <br />Start Date � I <br />Completed By ___ _ _ _ _ <br />Date Requested <br />Related Request <br />Estimated Hours <br />Job Costlnformation(Y/N) <br />Time Date Compieted tvs�zott Permit No <br />Time Follow Up? <br />�I3 <br />