HomeMy WebLinkAbout1977-09-19 Notice of Gas Service RepairMINNESOTA GAS CO. MAINTENANCE
❑ MAIN SERVICE P.C. NO�r,
DATE ? 7 MUNIC.0 ron0
LOCATION: 2765 F')X Street'
NATURE OF WORK Repair service
ORDER NO.
NARUC OR E NO.
RESP. ACCT. NO.
FOREIGN STRUC. PRESS. CL. SURFACE DISTURBED PIPE LENGTH
TELE a 1 ❑ ASPHALT ❑ OIL ❑ SAME
ELEC ❑ 3 ❑ CONCRETE ❑ DIRT FT LONGER
WU ❑ 3 ❑ BLVD ❑ WALK ❑ ALLEY FT SHORTER
OTHER ❑ 6 SIZE DISTURBED FT ABANDONED
SERVICE TAP MEASUREMENT
DATE STARTED �+ — 'DATE COMPLETED 3`" FOREMAN
To the (City Engineer
(City Council
(Village Council
(Town Board
The undersigned hereby requests permission to perform the work
indicated above.
MINNESOTA GAS COMPANY
By Q /
(Authorized Signature)
To the Minnesota Gas Company
Permission is hereby granted the Minnesota Gas Company to perform
the work indicated above.
Date
t. ,
By;
(Authorized Signature)
Form 45A R 1 1 /71