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Work Activity Work Order `a�- ' <br /> .-;'a;zot, r. . <br /> ISSU2d BY HLJ HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued uaizots <br /> Fund aot Account s Program Function Actiwry <br /> Program uraa�a 5 3 <br /> Tllle CONVERT 751NCH 1422 RUCKER AVE UT3a7J-5�3 <br /> WOfk �fdEf NO 20150326 Project Actiwty Type CORR[CTIV[(JAINTENANCE SIBSUS CL <br /> StaWs v<nois Timeoe7s OriginaiWO _________Billing __ _ _ _ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No C�N <br /> State Z'p <br /> Subdrvision Change Map Y!N <br /> Phone No ( I - Exi __ <br /> Seccnd Phone 1 ) - Ext <br /> E-Mad Address — . _ <br /> Problem Information <br /> Address �qyy Street RUCKERAVE <br /> From Cross Street <br /> To Cross Street <br /> City Z�p <br /> Subdivision ��iap Bcok A1ap Re`erence <br /> Prablem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> UUllry Locate(USA) No Called Date Expiration Dale <br /> Assignment Iniormation <br /> Dept Priority Eshmated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date __ To Be Comp Date _ <br /> Schedu�ed Date __ _ _ Scheduled Time _ _ _ <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CUR�STOP TO.751NCH SETTER WITH M[TER AND BOX.FLAT TO h7[TER <br /> PROJECT. <br /> Recommended Action <br /> Approved By wo� WEAVER,DEAN L. JOb COSI If1(Of1718I1Ot1(Y/N) _ _ <br /> Start Date � � Time Date Completed vsnots _ Permit No _ _ <br /> Completed By Time Foilow Up? <br />