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Work Activi�y Work Or�er pa5e - <br /> 1U�3�2Gi2 a:5e <br /> ISSUBd BY SJT2 SPOONER,JAMES T. <br /> Issued Department Pw PUBLIC WORKS <br /> Date Issued �i3vzo�z Activit <br /> Fund ao� Account s Program i�o Function »y y e�s <br /> Program <br /> TIfl2 REPAIR.%5 INCH 5117 tOTH AVE SE 710119675 <br /> Work OrdEr No 20121749 Project Activity Type CORRECTIVE MAINTENANCE Sf2tUS CL <br /> Status �rsvzoiz Time orzz Original WO _ _ ___ __ Billing <br /> Customer Information Customer ld <br /> Customer Name <br /> Address Street <br /> Apartment No City <br /> State Z�P <br /> Subdivision Change Map Y/N <br /> Phone No ( ) - Ext <br /> __- — - _ <br /> Second Phone ( ) • Ext <br /> E-Mail Address --- ------ --- <br /> Problem Information <br /> Address g��7 Street �OTHAVESE <br /> Fram Cross Slreet <br /> To Cross Street <br /> City Z�p <br /> Subdivision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated From <br /> Utility Locate (USA) No Cailed Date Expiration Date <br /> Assignment Information <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 JAKE DUG UP.75 INCH CURBSTOP.WILL REPLACE.751NCH CURBSTOP WITH.751NCH <br /> SETTER,JUMPER AND BOX. <br /> Recommended Action <br /> Approved By HLJ Husev,�nNCE�. Job Cost information(YIN) <br /> __ __--_-- Permit No <br /> Start Date � � Time Date Completed �iavzoi2 _ _ <br /> ____—.. <br /> _ __._ _ _ <br /> Completed By Time Follow Up <br />