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Work Activi�y Work Order PdQe 1 <br /> 12/19/2013 9:09 <br /> ISSUed By HLJ HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued 4N512013 <br /> Fund ao� Account 5 Program Function Activity <br /> Program UT3473 3 3 <br /> Title CONVERT.75 INCN 1616 MAPLE ST UT347333 <br /> Work Order No 20130749 PfOJBC� Activity Type CORRECTIVE MAINTFNANCE Sl8fU5 CL <br /> Status ansnois _ Time oa_os _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 Y/N <br /> Phone No ( ) - Ext <br /> Second Phone ( ) - Ext <br /> E-Mail Address ___ <br /> Probiem Infomiation <br /> Address 3003 Street EVERETT AVE <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WAYER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Reiated Request <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 <br /> Assigned Date To Be Comp Date __ <br /> `�'t'�;�'�y��1 � <br /> Scheduled Date _ _ Scheduied Time __ ,���� <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERi.751NCH CURBSTOP T0.751NCH SETTER WIM:TER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By wo� weAvert,oEnN�. Job Cost Information(Y/N) <br /> Start Date i � Time Date Completed tvvzota Permit No <br /> Comp'eted By Time Follow Up? <br />