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Work Activity Work Order Pd9� 1 <br /> _ _ _._.—_ _ ___-_ 3�i�zois ii:,o <br /> ISSUOd By HLJ HUSBY,LANCE J. <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued �nizute <br /> Fund ao� Account s Program »a Function »9 Activlry 6�5 <br /> Program <br /> TIIIE REPAIR .75 INCH 3400 NORTON AVE 710119675 <br /> WOfkOfdBfNO 20�5�5�� PfOJ2Cf ActivityType CORRECTIVEMAINTENANCE S1BtUS CL <br /> Status _ �ivzo�5 Time t3so Original WO Billing <br /> Customcr Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No Ciry <br /> State 7ip <br /> Subdivision Change Map .Y/N <br /> Phone No ( ) • Ext <br /> Second Phone ( 1 - Ext ---- - ____ <br /> E-Mail Address <br /> Problem Information --- - — — <br /> Address 3400 Sireet NORTON AVE <br /> From Cross Street <br /> Tc Cross Street <br /> Cit i Z�p <br /> Sub�ivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Indialed From <br /> Utdity Locate (USA) No Called Date Expiration Date <br /> Assignment Intormation <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned 6y <br /> Assigned Date _ _ To Oe Comp Date <br /> S^heduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONTRACTOR HIT WAiER SERVICE,WAS MISS I,OCATED NO CHARGE TO CONTRACTOR. PINCHf_D <br /> POLY AND PUT IN 4 FEET OF NC-W POLY..75"POLYWl.75"INS7q UNIONS <br /> Recommended Action <br /> AppfOVed By _q�� ARCHAMBEAULT.JOIIN J Job Cost In(ormation(Y1N) <br /> -- — - <br /> Slart Date � � Time _ Dale Completed ��»z�i5 Permit No <br /> -- - <br /> Completed By Time Follow Up� <br />