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Work Activity Work Order ;, = � <br />--- - --- -- - <br />:;;�. _ � .. <br />Issued By HLJ HUSBY, LANCE J. <br />Issued Departmentrw PueuC woRKs <br />Date Issued 111912016 <br />Fund aoi Account s Program Fu�c:ion Activity <br />Program ur3ata e a <br />TIIIO CO�VERT S INCH 3215 ROCKEFEILERlNE UT3473�9-3 <br />WorK Order No 20160280 Pro�ect Actrvity Type coRrtecnve r�tnwTevnNce Status c� <br />Stalus vi92o�5 Time i33� Onginal WO Bd,in <br />- - - -- -- <br />_ __ _ -- - _ . _ 9 <br />Customer Iniormation <br />Customer Name Cusromer ld <br />Address Street <br />Apartment No City <br />State Z�p <br />Subdivision Change tJlap YIN <br />Phone No ( ) • Ext <br />Second Phane ( 1 - Ext <br />E-Mail Address <br />Problem Intormation <br />Address 3P�g Street ROCKEFELLER AVE <br />From Cross Street <br />To Cross Streel <br />City Zip <br />Subdiwsion Map Book Map Reference <br />Problern WATER WATER <br />Sub Problem OTHER OTHER • <br />Requested By Date Requested <br />Agency Relaled Request <br />Inidated From <br />Utd�ty Locate (USA) No Called Date Expiration Date <br />Assig nmenl Information <br />Dep� Pnordy Estimated Hoirs <br />Crew <br />Contractor <br />Assigned To <br />Assigned By t y� i• <br />Assigned Date _____ To Be Comp Dale _Cl���� I'jd�f,b �� !_ `,,� �_.• <br />Scheduled Date Scheduled Time - ��''F~ �' <br />Route Route Sequence <br />Comments • <br />Action Taken CONVERT S INCH CURBSTOP T0.751NCN SETTER WITli METER AND BOx. FLAT TO h1[TER <br />PROGRAM. <br />Recommended Action <br />Approved By woL wenveR, oEnN �. Job Cost Information(Y/N) <br />--- — <br />--._ __ <br />Slart Date � � Time Date Completed �ns�zote _ Permit _ o___ <br />---- _.__- <br />Completed 6y Time Follow Up� <br />