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Vllork Activity Work Order '°-" <br /> nl::��,�a:� i3.�,:. <br /> — — — -- -- - — - -- <br /> ISSUE'.d B( HI.J HUSBY, LANCE J. <br /> Issued DeparimenlPw PUBLIC WORKS <br /> Date issued �onarzo�s <br /> Fund 4oi Account s Program Functwn Activ�ty <br /> Pwgram Ur7a�a s 7 <br /> T111C CONVERT 75 INCH 1910 70TH ST UT3e;g�5-3 <br /> WOfk Ofd2f NO 20152273 P�OjeCt Actiwty Type CORRECTNL MAINTENANCE SIdtUS CL <br /> Status �ori3rzois Time �� 5s Original WO Bil!ing <br /> Gustomer Information <br /> Customer Name Customer ld <br /> Address Street <br /> Apartment No City <br /> Stale Zip <br /> Subdivision Chanae Map Y/N <br /> Phone No � I - Ext <br /> Second Phone ( � - Ext <br /> E-Mail Address <br /> Problem Information <br /> Address �g�p Sfreet �OTH ST <br /> From Cross Street <br /> To Cross Street <br /> City Zip <br /> Subdivision M2p Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Uate Requested <br /> Agency Related Request <br /> IniUated From <br /> Utdity Locate (USA) No Called Dale Expiralion Date <br /> Assignment Information <br /> Dept Prionty Estimated Hours <br /> C rew <br /> Contractor <br /> F,ssigned To <br /> Assigned By � <br /> Assigned Date To Be Comp Date <br /> Scheduled Date Scheduled Time ; ,_ . ,. ' �� <br /> Route Route Sequence <br /> Comments <br /> Action Taken CONJERT JS INCH CURBSTOP TO]S INCH SETTER 'NITH �dETER AND BOX. FLAT TO METER <br /> PROGftAM. <br /> Recommended Aclion <br /> Approved By EAL ERICKSON,/1N�RElV L Job Cosl InformaUon(Y/N) <br /> Start Date i i Time Date Completed �on3izo�5 Permit No <br /> Completed By Time Follow Up� <br />