HomeMy WebLinkAbout1979-07-27 Gas Repair OrderMINNESOTA GAS CO MAINTENANCE ORDER NO
0 MAIN 9 SERVICE PAV, CUT NO. LEAK RPT NO
DATE R-)G_]Q MUNfC. h, -„n,, RESP ACCT NO
FPC or - ENO.
LOCATION 1L, 5 fll ti n.t vzn:r..
NATURE OF WORK .�.raaa.ar►a.ukri
FOREIGN STRUCTURES PRESS. CL. NEW SURFACE DISTURBED
Tele O 1 O A TAP O Road Mtn Bituminous ❑ Dort
Elec 02 p C SIZE O Hot Mia Bituminous O Gravel
O 5 O E CA Portland Cement Concrete n Oiled Earth
Light/Tral Cable 06 d F D Roadway 0 Blvd O W4114 0 Alley
Other L7 8 p K
Su• Onwrtsed
PIPE LENGTH O some _ Ft Longer Ft Shorter --- Ft Abandoned
SERVICE TAP MEASUREMENT
DATESTARTED COMPLETED FOREMAN IM Mat
TRUCK NO. TOWN NO. FOREMANS P.R. NO._.r
To the Icily Engineer
IC+ty Council
IVillage Council
(Town Board
The undersigned hereby requests permission to perform the w
indKamd above.
MINNESOTA GA COMPAfNJY
By Q
(Authon:ed Srgnsture)
To the Mlnnwots Gas Company
Permission is hwoby granted the Minnesota Gas Company to perform
the work indicated above.
of
Date By
(Authorized Signaulre)
FORM 45A R3/78