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� <br /> 2age 1 <br /> Work Activity Work Order g�3��a,5 B :SF <br /> - ----- - - <br /> ISSUBd BY WDL WEAVER,DEAN L. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued s�sizois <br /> Fund qo� Account 5 Program Function Activity <br /> Program UTJ673 6 3 <br /> TiUe CONVERT ]S INCH 1820 ROCKEFELLER AVE UT3473-6-3 <br /> Work Order No 20151767 Project Acliviry Type CORRECTIVE AMINTEN�NCE Status c� <br /> StaWs ai6no�s Time ie35 _ 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 l 1 - Ext _ _ _ <br /> — - - __ <br /> Second Phone ( ) • Ext <br /> E-Mail Address - - - - - —-- - <br /> Problem Informatian <br /> Address �gpp Slreet ROCKEFELLER AVE <br /> From Cross Street <br /> To Cross Street <br /> City ZiP <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Related Request <br /> �gency <br /> Iniliated From Ex iralion Date <br /> Utility Locale (USA) No Calied Date P <br /> Assignment Intormation Estimaled Hours <br /> Dept Priority <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned BY ''�' -"?�7 a�1f{r��_ �'1;) '_' �;; <br /> Assigned Dale To Be Comp Date <br /> Scheduled Date Scheduled Time <br /> Route Route Seq�ence <br /> Comments <br /> Action Taken CONVERT.751NCH CURBSTOP TO.751NCH SETTER MFTER AND BOX.FLAT TO METER <br /> PROGRAM. <br /> Recommended Action <br /> AppfOved By EA� ERICKSON,ANDREW L �Ob COSI IOfOff110110f1(Y/�l)_ , <br /> - Time Date Completed eno�to�s Permil No <br /> Start Dale � i —_ -- --- -- <br /> Completed By <br /> - Time Follow Up? <br />