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Work Activify Work Ordei pa9e 1 <br /> 4/3/2013 14:56 <br /> ISSU8C1 By SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued znzizo�a <br /> Fund aoi Account 5 Program Function 4ctivity <br /> Program UT347J z 3 <br /> TIYI2 CONVERT.75 INCH 3519 25TH ST UT3473-2•3 <br /> WOfk OfdOf NO 20130416 P�OJ2CI Activity Type CORRECTIVE MAINTENANCE S�8tU5 CL <br /> Status znzizois Time �s:ao Original W0 __ _ _ _ Billing ___ __________ <br /> Customer Information <br /> Customer Name Customer ld <br /> Addres, Street <br /> Apartment No ��ry <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( ) • Ext __ __ <br /> Second Phone ( ) - Ext <br /> E-MailAddress ___ _. __ ___--_ — <br /> Problem Information <br /> Adaress 3519 Street �STN ST <br /> From Cross Street <br /> To Cross Street <br /> City Z�p <br /> Subdivision Map Book fvlap Reference <br /> Froblem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initiated From <br /> Utility Locate (USA) No Called Date Expir2tion Date <br /> Assignment Information <br /> Dept Priority Estirc�ated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned 6y <br /> Assigned Da;e To Be Comp Date ____ <br /> Sct�eduled Date _____ Scheduled Time <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONVERT.75INCH CURBSTOP T0.751NCH SETTER WI METER AND BOX.FLAT TO METER <br /> PROJECT. <br /> Recommended Action <br /> Approved By RJP �PEIYEA,JASON P. JOb COSL If1fOf�118[IOfI(Y/N� _ <br /> Start Date i I Time __ _ Date Completed a/sizot3____ Permit No <br /> Completed By Time Folloe� Up? <br />