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Work Activity Work Order page � <br /> 12/20/2014 1]:10 <br /> ISSU@d By HLJ HUSBY,LANCE J. <br /> Issued Department Pw VUBLIC WORKS <br /> Dale Issued 10116I7074 <br /> Fund �ot Account s Program »o Function i�q Activity 675 <br /> Program <br /> Titie REPAIR 75 INCH 1427 100TH ST SW N1 U 710111675 <br /> WOfk O�dCE NO 2G143125 PfOJ@Cl Activiry Type CORRECTIVE MAINTENANCE Sf81U5 CL <br /> Status tm�5rso�o Time �a�o Ori�inal WO Billing _ _ <br /> Cuatomer Inlormation <br /> Customer Name Customer ld <br /> Address Street <br /> Apartmenl No ��N <br /> State Z�P <br /> Subdivision Change Map YIN <br /> Phone No ( 1 - Ext <br /> Second Phone c 1 • Ext - " — <br /> E•Mail Address <br /> Problem Information <br /> Address 14Y7 p��q Stree4 �OOTH S T S W <br /> From Cross Street <br /> To Cross Street <br /> C�ty Zip <br /> Subdrvision Map Book Map Reference <br /> Problem WATER WATER <br /> Sub Problem OTHER OTHER <br /> Requested By Date Requested <br /> Agency Related Request <br /> Initia�ed From <br /> Uliliry Locate (USA)No Called Date EzpiraGon Date <br /> Asslgnment Informatlon <br /> Dept Priority Eshmated Hours <br /> Crew <br /> Contractor <br /> Assigned To <br /> Assigned By <br /> Assiqned Date To Be Comp Date I <br /> Scheduled Dale _ _ ___ Scheduled Time ii <br /> Route Route Sequence I <br /> . Commenta I <br /> Actlon Taken FLAT TO SERER.INST.�LIED.76 iNCH SFTTER AND JUMPER WITH METER BOX <br /> Recommended AcNon <br /> Approved By wo� WEAVER,DFAN L Job Cost Information(Y/N) <br /> Start Date r � Time Date Completed toner2ou Permit No <br /> Completed By __ Time _ Follow Up? <br />