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rw^m- <br />MINNESOTA GAS CO. MAINTENANCE <br />O MAIN 1^ SERVICE PAV. CUT NO. <br />DATE 9-9-31 MUNic. Or#no <br />ORDER NO. <br />LEAK RPT, NO. <br />RESP. ACCT. NO. <br />FPC -or -E NO. <br />7117 <br />39/ <br />LOCATION 286^5 Casco Politt <br />NATURE OF WORK Reo« Ir Sc^rv Ic ? <br />FOREIGN STRUCTURES <br />T«l« <br />El«c <br />Liyht/Traf. Cabla <br />Oihar <br />PRESS. CL. <br />□ 1 □ A ‘ <br />□ 2 □ C <br />n 5 a E <br />a 6 a F <br />□ 8 a K <br />H <br />NEW <br />TAP <br />SIZE <br />SURFACE DISTURBED <br />O Road Mix Bituminous O Dirt <br />O Hot Mix Bituminous O Gravel <br />CJ Portland Cement Concrete D Oiled Earth <br />O Roadway O BUd. Cj Walk Cl Alley <br />Size Disturbed <br />PIPE LENGTH O Same Ft. Longer Ft. Shorter Ft. Abandoned <br />SERVICE TAP MEASUREMENT <br />DATE STARTED <br />TRUCK NO. ___ <br />«»Sv COMPLETED 3- /-31 FOREMAN__ <br />— TOWN NO-------------------------FOFiLMANSP.R. NO. <br />Sza£larstcl <br />To th« (City Enginoor <br />(City Council <br />(Village Council i ' <br />(Town Board % <br />The undersigned hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GA^OMPANY <br />/J (Authorired Signature) <br />To the Minnesota Gas Company <br />Parminion it hereby grented the Minnesota Get Company to perform <br />tha ysork indicated ebove.r <br />... rrf', <br />f - /-< 9/ <br />[Authori/ecJ Signature 1 <br />FORM 4SA R3/78 <br />iiia