HomeMy WebLinkAbout1977-04-07 Notice of Gas Service Repair'^33
MINNESOTA GAS CO. MAINTENANCE ORDER NO.
❑ MAIN Il SERVICE P.C. NO NARUC OR E NO. "
DATE # ` �' MUN IC. RESP. ACCT. NO.
LOCATION:
NATURE OF WORK
FOREIGN STRUC.
PRESS. CL.
SURFACE DISTURBED
PIPE LENGTH
TELE
❑
❑
1
❑ ASPHALT ❑ OIL
❑ SAME
ELEC
❑
❑
2
3
❑ CONCRETE ❑ DIRT
FT LOF409M
wu
❑
a
[:]BLVD ❑ WALK ❑ ALLEN
FT SHORTER
OTHER
❑
SIZE DISTURBED
FT ABANDON
SERVICE TAP MEASUREMENT
TE STARTED DATE COMPLETED FOREMAN
To the (City Engineer
(City Council
(Village Council
(Town Board
The undersigned hereby requerts permission to perform the work
indicated above.
MINNESOTA GAS COMPANY
By
(Authorized Signature)
To the Minnesota Gas Company
Permission is herby granted the Minnesota Gas Company to perform
the Work I idicated above.
Date
Form 46A Rt 1/71
of
By
(Authorized Signature)