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Work Activity Work Order Page 1 <br /> s�i��z��a ii:sz <br /> _ __ --- ---- <br /> ISSt10d By SJT2 SPOONER,JAMES T. <br /> issued Department Pw PUBLIC WORKS <br /> Date Issued vzaizota <br /> Fund qoi Account s Program »o Function ite Activity s�5 <br /> Program <br /> TIiIB REPAIR.75 INCH 210 48TH ST SW 710119675 <br /> Work Order No 20140307 PfOJBCf Activity Type CORRECTIVE MAINTENANCE St2tUS CL <br /> Status vzs�zoia Time oe:se _ Original bV0 ___ Billing_ _________ __ <br /> Customer lnformation <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 ( ) - Ext _ _ __ <br /> Second Phone ( ) - Ext - <br /> E-Mail Address ___._____ —_ __— <br /> Problem Information <br /> Address p�p Street 48TN ST SW <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OThER OTHER <br /> Requested By Date Requested <br /> Agency Refated Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expiration Date <br /> Assignment Information <br /> Dept Priority Estimated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assigned Date �o Be Comp Date <br /> Scheduled Date ___, ___ Scheduled Time <br /> Rcute ?oute Sequence <br /> Comments <br /> Action Taken REPLACE.75 INCH CURBSTOP WITH.75 INCH SETTFR,JUMPER ANO BOX.CURBSTOP WAS <br /> NOT UPRIGHT. <br /> Recommended Action <br /> Approved By WDL WEAVER, DEAN L. JOb COSY If1fOf�118t1Of1(Y/N� <br /> - ------ Permit No <br /> Start Date i i Time Date Completed vzalzo�a ____ ______ <br /> - ---_ ---- <br /> Completed By Time Follow Up? <br />