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Vi/ork Activit Work Order °'�e 1 <br />Y :/3/20L ?5:30 <br />ISSU2d By � HLJ HUSBY, LANCE J. <br />Issued Department aw PUBLIC WORKS <br />Date Issued 317/2073 <br />Fund ao� Accounts Program <br />Program UT3473 z a <br />Tlfle CONVERT .5 INCH 3115 16TH ST UT3473-23 <br />Work Order No 2013�616 Project <br />Status smzois Time os_s5_ Original WO_ <br />Function Activity <br />Activity Type CORRECTIVE MAINTENANCE SfOfUS CL <br />Bilting_ <br />Customer Information <br />Customer Name Customer ld <br />Address Street <br />Apartment No City <br />State Z�P <br />Subdivision Change Map Y/N <br />Phone No � 1 • Ext __ <br />Second Phone ( ) - Ext <br />E-Mail Address ___ — - <br />Problem Information <br />Address 3115 Street �6TH ST <br />From Cross Street <br />To Cross Street <br />City Z�p <br />Subdivision Map Book Map Reference <br />Problem WA1'ER WATER <br />S b P oblem OTHER UTHER <br />u r <br />Date Requested <br />Requested By Related Request <br />Agency <br />Initia[ed From <br />Utility Locate (USA) No Called Date Expiration Date <br />Assignment Information <br />Dept Priority Estimated Hours <br />Crew <br />Contractor <br />,4ssigned To <br />Assigned By <br />Assigned Date ______.. To Be Comp Date __ ___ <br />Scheduied Date .. ___ _.. Scheduled Time _. ___ <br />Route Route Sequence <br />Comments <br />Action Taken CONVERT .5 INCH CURBSTOP TO .75 INCH SETTER WI METER AND BOX. FLAT TO METER <br />PROJECT. <br />Recommended Action <br />Approved By HLJ HUSBY, iANCE J. <br />--- <br />-- — <br />Start Date i i Time <br />Completed By <br />Job Costlnformation(YIN) <br />Date Completed a�2oim� s.___ Permit No <br />Time Follow Up? <br />