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Work Activity Work Order ' " <br />. .._ ..:� .:;�. <br />_ - - - - ---- - <br />Issued By HLJ HUSBY, LANCE J. <br />Issued Department Pw PUBLIC WORKS <br />Date Issued 1119f2016 <br />Fund ao� Account s Progrem Function Actwity <br />Program uraa�a 9 s <br />Title CONVERT 751NCH 3532 ROCKEFELLER AVE UT3473�9J <br />Work Order No 20160255 PtOJ@Cl Actwity Type CORRECTN[ MAINT[NANCE <br />Staws �+e,zoie T�me �z ze Original W0 _ B�Iling <br />Customer Information <br />Customer Name Customer ld <br />Address Street <br />Apariment No C�ry <br />State Z�p <br />Subdrvision Change Map YIN <br />Phone No � 1 - Ext <br />Second Phone ( � • Ext <br />E-Mail Address <br />Problem Information <br />Address 3632 Street ROCKEFELLER AVE <br />From Cross Street <br />To Cross Sireet <br />City Zip <br />Subdrvision t�9ap Book Map Reterence <br />Problem WATER WATER <br />Sub Problem OTHER OTHER <br />Requesled By Date Requested <br />Agency Related Request <br />Initiated From <br />Uid�ty Locate (USA) No Called Date Expiration Date <br />Assignment Information <br />Dept Priority Estima;ed Hours <br />Crew <br />Cuntractor <br />Assigned To G►? a'�r� r�. ,• <br />Assi nedB �`''���� <br />9 Y To Be Com Date �'�;' '�' <br />�ssigned Date P <br />Scheduled Date Scheduled Tlme <br />Roule Ro�te Sequence <br />Comments <br />Action Taken CONVERT JS INCH CUR85TOP TO JS INCH SETTER WITH f."ETER AND BO%. FLAT TO �.1ETER <br />PROGRAM. <br />SIalUS CL <br />Recornmended Action <br />Approved By wo� WCnVER, DEAN L Job Cost In(ormaGon(Y/N) <br />Start Date � i Time Date Completed vzvzoi6 Permrt No <br />Completed By Time Follow Up� <br />