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Worlc Activity Work Order ���° 1 <br /> -:i�s;«�; . ._s <br /> Issued By HLJ HUSBY,LANCE J <br /> Issued Department aw PUBLIC WORKS <br /> Date Issued to�zvmia <br /> Fund ao� Account s Program Funct�on Hc;n��fy <br /> Program uTaa�s s a <br /> Till@ CONVERT 751NCH 1602 WETIdOR[AVE UT3473-6�3 <br /> Work Order No 20143155 PfOJBC� Activity Type CORRECTIVF IdA1NTENANCE $10iU5 CL <br /> Status �orzuzoia Time m iz Onginal WO Billing _ _ _ ___ __ ____ <br /> Customer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Exl <br /> Second Phone ( l - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address �5p2 Street WETMOREAVE <br /> From Cross Street <br /> To Cross Slreet <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requesled <br /> Agency Reiated Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Explration Date <br /> Assignment Informalion <br /> Dept Prion�y [slimaled Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time _ <br /> Roule Route Sequence <br /> Comme�ts <br /> Action Taken CONVERT.75 INCH CURB STOP TO.751NCH SETTER WITH M1iETER�ND BO%. FLAT TO METER <br /> PROJEC"f. <br /> Recommended Action <br /> Approved By wo� W�veR,oenN� Job Cosl Information(Y/N) _ <br /> Start Dale � i Time Date Compleled tonono�a _ Permit No <br /> Completed �y Time Follow Up7 <br />