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i <br /> � <br /> � <br /> Page 1 <br /> Work Activity Work Order lo„1,Zo12 ,:SZ <br /> ISSUed BY � SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued taiv2o�z Activi <br /> Fund aot Account 5 Program �to Function �te �y 675 <br /> Program <br /> Title CONVERT.75 1NCH 2531 PINE ST 770119675 <br /> Wark Order No 20122253 Project Activity Type CORRECTIVE MAINTENANCE S�dfUS CL <br /> Status toni2otz Time �a:zo OriginalWO Billing ___ ___._ ____—_--— <br /> Customer Intormation Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( ) • Ext _ ___ _— <br /> Second Phone ( 1 • Ext <br /> E-Mail Address — -- -- <br /> Problem Information <br /> Address 2531 Street p�NE ST <br /> From Cross Street <br /> To Cross Street <br /> City Z�P <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Related Request <br /> Agency <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 To Be Comp Date <br /> Assigned Date _____ — — <br /> Scheduled Date ___. Scheduled Time __ _____ <br /> Route Route Sequence <br /> Comments <br /> Action Taken REPLACE.75 INCH CURBSTOP WITH.75 INCH SETTER WITH METER AND BOX.FLAT TO <br /> METER OWNER REQ. <br /> Recommended Action <br /> Approved By SDG SMITH,DAVID G. JOb C051 Ifl`OfR18ti0f1(YIN� _ <br /> Start Date � i Time ____ _ Date Completed toni2otz _ Permit No _ <br /> Completed By Time Follow Up7 <br /> i <br />