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Page i <br /> iNork Acti�ity Work Order ,,z„ZaIZ 1�:;� <br /> Issued By SJT2 SPOONER,.IAMEST. <br /> Issued DepartmentPw PUBLICWORKS <br /> Date Issued eismu�z Function »e Activity s�5 <br /> Fund ao� Account 5 Program »o <br /> Program <br /> Title REPAIR.75 INCH 2504 5TH ST 710119675 <br /> Work Order No Z��z2z43 PfOJOCf Activiry Type CORRECTIVE MAINTENANCE Sf8fU5 PR <br /> StaWs emizot2 Time �as3 Original WO _ Biliing <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 ( 1 - E�.t _ _-- <br /> Second Phone ( ) - Ext <br /> E-Mail Address — <br /> Problem Information <br /> Address 2504 Street 5TH ST <br /> From Cross Street <br /> To Cross Street <br /> City Z�p <br /> Subdivision Map Buok Map Referenr,e <br /> Prablem WATER WATER <br /> Sub Problem OTHER OTHER Date Requested <br /> Requested By Related Request <br /> Agency <br /> Initiated From Ex iration Date <br /> Utiliry Locate (USA) No Called Date P I <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 /> Raute Route Sequence <br /> Comments <br /> Action Taken CONVERT.75 INCH CURBSTOP TO.75 INCH SETTER WITH JUMPER AND BOX.CONTRACTOR <br /> HAS EXPOSED FOR SMELTER CLEAN UP. <br /> Recommended Action <br /> Approved By _ Job Cost Information(YIN) <br /> Date Com leted i � Permit No <br /> StartDate i i Time _ P _� Lj �Z <br /> P Y s.��— Time Follow Up? <br /> Com leted B <br /> y <br />