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Work Activity Work Order <br />Page 1 <br />12�2,�2�12 15:4, <br />ISSUBd BY SJT2 SPOONER,JAMEST. <br />Issued Department Pvi PUBLIC WORKS <br />Date Issued 1013�����2 pro rem Function Activity <br />Fund ao� Accounts 9 <br />Program ur3a�s z s <br />TIII2 CONVERT .75 INCH 2O05 STATE ST UT3473-2-3 <br />WO�k OfdBf NO 20122495 PfOJOCf Activity Type CORRECTIVE MAINTENANCE <br />Status ioi3v2oiz Time �a.aa _OriginaiWO _Billing_ <br />Customer Information Customer ld <br />Customer Name <br />Address Street <br />Apartment No City <br />Slate Z�P <br />Subdivision Change Map Y/N <br />Phone ��o ( 1 - Ext _ __ . _ <br />Second Phone ( ) - Ext <br />E-Mail Address — – <br />Problem Intormallon <br />Address 2005 Street STATE ST <br />From Cross Street <br />To Cross Street Zip <br />City <br />Subdivision Map Book Map Reference <br />Froblem WATER WATER <br />OTHER <br />Sub Problem OTHER Date Requested <br />Requested By Related Request <br />Agency <br />Initiated From Ex iration Date <br />Utility Locate (USA) No Called Date P <br />Assignment Infonnation <br />Dept Priority Estimated Hours <br />Crew <br />Contractor <br />Assigned To <br />Assigned By To Be Comp Date <br />Assigned Date ___ _ ___ _ -- <br />Scheduled Date _ Scheduled Time _ _ __ <br />Route Route Sequence <br />Comments <br />Action Taken CONVERT .75 INCH CURBSTOP TO .751NCH SETTER WI METER AND BOX. FLAT TO METER <br />PROJECT. <br />Recommended Action <br />Fpproved 8y HLJ HUSBY,LANCEJ. <br />Start Date � � _ __ Time <br />Completed By <br />� <br />SfBtUS CL <br />Job Costlnformation(YIN) <br />Date Completed tv�onotz _ Permit No _ <br />Time Foliow Up? <br />Y3 <br />