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Page 1 <br /> Work Activity Work Order 6/6/2013 ii:a� <br /> ISSUBd By HLJ - HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLIC WORKS <br /> Date Issued 4M612013 pro ram Function Activity <br /> Fund aot Account s 9 <br /> Program UT3473 s s <br /> TI►IP. CONJERT.751NCH 2103 MAPLE ST UT347333 <br /> Work Order No 20130780 PfOJBC� Activity Type CORRECTIVE MAINTENANCE SfBIUS CL <br /> StBtUS 41i6/2013 TIRIe 13:48 Ofiglf181 WO _ __ _____ _ . __Bllllflg _ __ __---- <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No ��ry <br /> State Z�p <br /> Subdivision Change Map Y/N <br /> Phone No ( ) • Ext ---_- -_----- -. ---- <br /> Second Phone ( ) • Ext <br /> E-Maii Address - - - - --- - -- - —--—" <br /> Problem Information <br /> Address 2103 Street MAPLEST <br /> From Cross Street <br /> To Cross Street Z�P <br /> Ciry Map Book Map Reference <br /> Subdivision <br /> Problem WATER WATcR <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiate�l From Ex iration Date <br /> Utility Locate (USA) No Called Date P <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 /> Scheduied Date _ Scheduled Time _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP T0.751NCH GETTER WIMETER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By HW iiusev,�nNce d. Job Cost Information(YIN) <br /> -- — <br /> Time Date Completed 5I61Y0'13 Permit No__ <br /> Start Date � i _— - <br /> —- ---- <br /> Completed By Time Follow Up. <br />