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Work Activit� Work Order F�g� = <br /> �;a;zois .z �: <br /> ISSUCd By SJT2 SPOONER,JAMES T. <br /> Issued Departmentcw PUBLICWORKS <br /> Date Issued �ziu�2o�a <br /> Fund ��., Acccunt s Program Function Activity <br /> Program uraa» e a <br /> Tdle CONVERT 75 WCH 12206'�EThARE AVE UT3C7&6J <br /> WOfk �fd2f NO 20143530 PfOJCC� Actiwty Type CORRECTIVE t.1AINTENANCE SfafUS CL <br /> Slatus iznzrzoia Timet2a3 OrigmalWO Btlling <br /> Customer Iniormation <br /> Customer Name Cusromer ld <br /> Address Street <br /> Apartment No City <br /> State Zip <br /> Subdivlsion Change Map YiN <br /> Phane No ( i • Ext <br /> Second Phone l ) - Ext - - -- <br /> E-Mail Address <br /> Problem Information <br /> --- - - --- <br /> Address iyyp Slreet yyETMOREAVE <br /> From Crass Sireet <br /> To Cross Street <br /> Ciry Z�q <br /> Subdivision Map Qook Map Reference <br /> Prob�em WATER WATER <br /> Sub Problem OTHER 07HER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Ul�hty Locate(USA} No Called Date ExptraUon Date <br /> Assignment Informatic n <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> AssiSned �y <br /> Assigned Date To �e Comp Date <br /> Scheduled Date Scheduled Time ��' �' � �� :�"a �„ ��� r �t? <br /> Roule Route Sequence <br /> Comments <br /> Action Taken CONVERT .751NCH CURBSTOP T0.751NCH SETTER WITH METER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By wo� we<.vert, oes�N�. Job Cost Informalion(Y/N) <br /> Start Date � i Time Date Completed L�oizo�s Permit No <br /> Completed By Time Follow Up7 <br />