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Wor4c Activity Work Order �a�� � <br /> _.—_—___ _.__________._.___ . 3!9/=0:5 _. .:9 <br /> ISSU2d BY SJT2 SPOONER,JAMES T. <br /> issued DepaRmentrw PUBLL^WORKS <br /> Date Issued tzuizo�a <br /> Fund 4oi Acccunt 5 Program FuncUon Act�vity <br /> Program uTaa�s s a <br /> Tllle CONVERT 75 INCH 1202 VJETI.tORE AVE Ui3473�6�3 <br /> Work Order No Z0�43526 PfOfCCI Activity Type CUNRECTIVE tdAINTENANCE $fOtUS CL <br /> Status_ _ �znz�zoia Time �z 3� Original WO Billing <br /> Customer Information <br /> Gustomer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�o <br /> Subdivision Change Map Y/N <br /> Phone No ( I • Ext <br /> Second Phone ( 1 • Ext <br /> E-Mail Address <br /> Problem Information - -- - - <br /> Address �ypZ Street pyETMORfAVE <br /> From Cross Street <br /> To Cross Street <br /> Ciry 7_ip <br /> Subd�ws�on Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Imt�ated From <br /> Uhhty Locate(USA) No Called Date Exptration Date <br /> Assignment Information <br /> Depl Pnonty EsUmated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned �y <br /> Assigned Date ___ To Be Comp Dale <br /> Scheduled Dat� Scheduled Time ;��� �� '�� ��� " �`�> �'� �'� <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.751NCH CUR85TOP TO.751NCH SETiER WITf1 METER AND BOX.FLqT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By wo� w�vert oenN� Jeb Cosl Informatbn(Y�N) <br /> "'�rt Dale _ � � Time __ Date Completed z�enots � Permit No <br /> Completed By Time Follow Up7 <br />