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W�rk Activity Work Order �ag� ' <br /> :i/zs/zoia �:<3 <br /> ISSUed By HLJ HUSBY,LANCE J. <br /> Issued Department Pw pUBLIC WORKS <br /> Date Issued �oizvzoia <br /> Fund aoi Account s Program Function Aclivi(y <br /> Program UTJC73 s a <br /> TIfl2 CONVERT JS INCH 7620 WETNOF:E AV[U i;f473-6�3 <br /> Work Orde' NO Z��43�60 P�OjECI Activity Type CORRECTNE IJAINTENFNCE $12IUS CL <br /> Status torzvzo�a Time o�3e Original WO Billing _ _ ___ _ <br /> Customer Information <br /> Cuslomer Name Customer ld <br /> Address Street <br /> Apartment No Ciry <br /> State Zip <br /> Subdivision Change Map 1'/N <br /> Phone No 1 1 - Ext <br /> Second Phone t I • Ext - -- -- — -- - <br /> E-Mail Address <br /> Problem Information <br /> Address �gZp Street pyETMOREAVE <br /> From Cross Streel <br /> To Cross Street <br /> C�ty 7ip <br /> Subdivision 61ao f3ook Iv1ap Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OrHER <br /> Re �uested By Date Requested <br /> Agency Related Request <br /> Iniliated From <br /> U61�ty Locate(USA) No Called Date [xpiralion Date <br /> Assignment Information <br /> Dept Prionty Estimated Hours <br /> Creva <br /> Conlractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date l o Be Comp Date <br /> Scheduled Date __ Scheduled Time _ <br /> Raute Route Sequence <br /> Comments <br /> Action Taken CONVERT]S INCH CURE3 S70P TO 351NCN SETT[R WITH MET[R AND BOX.FLAT TO h1ET[R <br /> PROJECT. <br /> Recommended Action <br /> Approved 6y wo� �vFf,veR oF�N� Job Cusl Imormalion(Y/N) <br /> Start Date i � Time Date Compleled �orzono�a Permit No <br /> Compleled By Time Follow Up� <br />