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Work Activity Work Order ° - � <br />-- - _ —__ ---- - --- _-- <br />:,.. _ <br />ISSU2d By HLJ HUSBY, LANCE J. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 171912016 <br />Fund eo� Account 5 Program Function Actwity <br />Prcgram UT3473 -9 s <br />T41E COYVERT 75 INCFI �627 ROCKEFELLER �VE UT3473-9-3 <br />I Jork Order No 20160264 Pro�ect Act�vity Type COHf2ECTIVE 1dAINTEW>NCE Status c� <br />Sfatus ___ +r�o2oie Time �Z 52 _ Or�gmal WO B�'lirg <br />Customer In(ormation <br />Customer Name Custorner ld <br />Address Street <br />Apartment No C�ty <br />State Z�p <br />Subaiwsion Chanqe Map Y;N <br />Phone No ( ) - Exl <br />Second Phone � � - Ext — ---- -- <br />E-Mail Address <br />Problem Information <br />Acldress 36P7 Street ROCKEFELLER AVE <br />Fram Cross Street <br />To Cross Streel <br />City Z�o <br />Subd�vision Map �ooh hiap Reference <br />Problem WATEF2 WATER <br />Sub Probiem OTHER OTHEP. <br />Requested By Date Requested <br />Agency Related Request <br />Indialed From <br />Uhlity Locate (USA) No Called Date Expiration Date <br />Assignment Information • <br />L�ept Pra�ty Estimaled Hours <br />Crew <br />Contractor <br />Assigned ?o <br />,, <br />Assigned By ,,:,,.; �° �3g <br />,lssigned Date To Be Cornp Date � �' '• �' : , � <br />-- __ U[7U��,-- <br />Scheduled Date Scheduled Time <br />Ro��te Route Sequence <br />Comments <br />Action Taken CONVERT J51NCH CURBSTOP TO 751NCH SETTER WITH h1ETER AND BOX FLAT TO fdETER <br />PROGRAh1. <br />Recomm�nded Action <br />Approved By y�p� WEA�/ER, QE�N L Job Cos� Information(YiM <br />Start Date i i Time __ Date Completed u22�zoi5 Permit No <br />Compteted By Time Folla:v Up� <br />