Laserfiche WebLink
MINNESOTA GAS CO. MAINTENANCE ORDER NO. ' ; 0 <br />❑ MAIN W SERVICE PAV. CUT NO. LEAK RPT. NO. <br />DATE 1 2- 1 e- 7 q MUNIC. 0 r O f1 0 RESP. ACCT. NO. <br />FPC - or -E NO. r Q! <br />LOCATION: 3505 Crystal P lace <br />NATURE OF WORK R e Q a i r -St., V i C P <br />FOREIGN STRUCTURES <br />PRESS. CL. <br />NEW <br />SURFACE DISTURBED <br />Tel@ <br />Q t Q A <br />TAP <br />❑ Road Mix Bituminous ❑ Dirt <br />Elec <br />0 2 Q C i <br />SIZE <br />0 Hot Mix Bituminous ❑ Gravel <br />Q 5 Q . i <br />El Portland Cement Concrete O Oiled Earth <br />Light/Tref. Cable <br />Q 6 C.] <br />❑ Roadway ❑ Blvd. 0Walk Q Alley <br />Q 8 Q <br />LI <br />Size Disturbed <br />Other <br />PIPE LENGTH ❑ Some Ft. Longer Ft. Shorter Ft. Abandoned <br />SERVICE TAP MEASUREMENT <br />' DATE STARTED COMPLETED FOREMAN <br />L TRUCK NO. TOWN NO. <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />FOREMANS P.R. NO. <br />The undersigned hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GA ANY <br />BY <br />/ (Authorized Signature) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform <br />the work indicated above. <br />C + A u of fJ L-) <br />Date �' `• t 1( By <br />(Authorized Signature <br />FORM 45A R3/78 <br />