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Work A�tivity Work Order <br />ISSUEd By HLJ HitSBY, LANCE J. <br />Issued DepartmentPw PUBLICWORKS <br />Date Issued aite�xota <br />Fund ao� Account s Program <br />Program UTJ473 a � <br />Title CONVEHT .751NGH 3071 21ST ST UT3473-3-3 <br />Work Order No 20130785 Project <br />Status a�teizot3 Time �a:oe Original WO <br />Customer Information <br />Customer Name <br />Address <br />Apartment No <br />State <br />Subdivision <br />Phone No � � • <br />Second Phone ( > - <br />E-Mail Address <br />Problem Information <br />Address 3011 <br />From Cross Street <br />To Cross Street <br />City <br />Subdivision <br />Problem WATER <br />Sub Problem pTHF_R <br />Requested By <br />Agency <br />Initiated From <br />Utiliry Locate (USA) No <br />Assignment Information <br />Dept <br />Crew <br />Contrector <br />Assigned To <br />Assigned By <br />Assigned Date _ __ _ <br />Scheduled Date ____ <br />Route <br />Comments <br />Street <br />City <br />Zip <br />Ext <br />Ext <br />Street Z�ST ST <br />WATER <br />JTNER <br />Activiry Type <br />Map Book <br />Called Date <br />To Be Comp Date <br />Scheduled Tirne <br />Route Sequence <br />Function <br />Customer ld <br />Zip <br />Pricriry <br />Paae 1 <br />5/5/20'_3 1'_:37 <br />Activity <br />CORRECTIVE MAINTENANt,E SfafUS CL <br />Change Map YIN <br />Map Reference <br />Date Requested <br />Related Request <br />Expiration Date <br />Estimated Hours <br />Action Taker, CONVERT.75 INCH CURBSTOP TO .75 INCH SETTER W/METER AND BOX. FLAT TO METER <br />FROJECT. <br />Recommended Action <br />Ap�iroVEd By HLJ_HUSBY_LANCE J <br />Start Date � !_ <br />Compieted By <br />Job Cost Information(Y/N) <br />Time Date Completed sn�zoia _ Permit No <br />Time Follow Up? <br />