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Work Activity Work Order Pa9e � <br /> ��za�zois s z� <br /> ISSUCd By HlJ HUSBY,LANCE J. <br /> Issued Departmentaw PUBLICWORKS <br /> Date Issued 611 612 01 5 <br /> Fund aa� Account s Program Function Activity <br /> Program UT3073 e � <br /> Tifle CONVERT 75 INCH 191 J OAKES nVE UT3479�6-7 <br /> Work Order No Z��5�4Z0 PfOJ2Cl Activiry Type CORRECTIVE MAINTENANC[ $iafUS CL <br /> Status 5iisrzo�s Time m os_Original WO __ Billin9 ______ ___ <br /> Customer Infortnation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No C�ry <br /> Stale Z�P <br /> Subdivision Change Map YIN <br /> Phone No l 1 • Ext <br /> Second Phone ( � • E� <br /> E-Mail Address __ _ __ __ <br /> Problem Information <br /> Address 19i3 Street OAKES AVE <br /> From Cross Street <br /> To Cross Street <br /> Ciry ZiP <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Relaled Request <br /> Ini6ated From <br /> Utility locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Prioriry Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By To Be Comp Date ���'��� �: ���� <br /> Assigned Date __. _ _ �,'.? ' . <br /> Scheduled Dale Scheduled Time <br /> Route Roule Sequence <br /> Comments <br /> Action Taken CONVERT.75INCH CURBSTOP T0.751NCH SETTER WITH METER AND BOX.FLAT TO MEIER <br /> ;ROJECT <br /> Recommendr.d Action <br /> Approved By En� ERICKSON,ANDREW L. JOb COSI If1(OffTl2llOt1(YIN) <br /> Start Date i � Time Date Completed ena�zo�5 __ Permit No <br /> Completed By Time Follow Up? <br />