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Work Activity Work Order =ayP 1 <br /> :�/;s��o�a �:_s <br /> ISSU2d By HLJ HUSBY,LANCE J. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued �omrzo�a <br /> Fund aot Account s Program Funclion Activ�ty <br /> Program uraan 6 3 <br /> TIllB CONVERT 75INCH 1632 WETI.70RE AVE UT3a73-6�3 <br /> Work Order Na 20143163 PfOfBCf Actiwty Type CORRECTIVE IdAINTENANCE S18fU5 CL <br /> Status iorz�rao�a Time o�:s Original WO Billing _ __ _ _ __ _ _ __ <br /> �ustomer Information <br /> Cuslomer Name Customer ld <br /> Address Sfreet <br /> Apartment No City <br /> State Z�P <br /> Subdivisior� Chanc Map Y!N <br /> Phone No ( 1 - Ext <br /> Second Phone ( ) - Ext - — — <br /> E-Mail Address <br /> Problem Information <br /> Address 163P Street yyETMOREAVE <br /> From Cross Street <br /> To Cross Street <br /> City 2ip <br /> Subdivision Map Book Iviap Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER UTHER <br /> Requesled By Date Requested <br /> Agency Related Requesl <br /> Initialed From <br /> Utdity Locate(USA) No Called Dale Expiration Date <br /> Assignment Information <br /> Depi Priority Estunated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date _ To Be Comp Da!e <br /> Scheduled Date Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.75 INCH CUR9 STOP TO.75 INCH SETTER WITH NETER AND BOX. FLAT TO �J�[TER <br /> PROJECT. <br /> Recommended Action <br /> Approved By wo� wenveR,oEnN� Job Cosl Informalion(Y/N) <br /> Start Dafe i � Time __ _ _ Dale Compieted �oizoizota ____ Permit No _ <br /> Completed By Time Follow Up� <br />