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HomeMy WebLinkAbout1987-000128 (SAC) -. ' p I '�_ � � �'ERMIT � ��Y OF �►RONO � � PER�JIIT TYPE: ��wE�ry� w��E� ; j Brown Rd. South • P.O. Box 66 Permit Number. �-�����''�'� �tal Bay, Minnesota 55323 Date tssued: �����f�l�C'? , ; !) 473-7357 � � qDDRES�: - � . i���� ��:�� �T � - i - � - -i ►cRiP-rioN: � � � � `:�w�r � Wdfi�r F'�rrl�i� T�r�� �A� C�RlLY ��w�r � Wat�r �t�ark TY�� ���IdEIVCE � � I , ; - � ��`� i . , , . I . . . _ . - .�� ; � � . � ; � , � FEE SU11ItMARY. - . ' ���� ��� �.�}�f � � �►A� �5��.c:it� � _ �PlC: � �,���i . ; �:AG �an i�� _____ _� � T���1 F�� � ���a:�5.��� ' - j . 4 i . _ � , � f I � i � CONTR�ACTOR: OWNER: -- ���1ac��� -- � ` pC��it�cyc3�? Et�t�l� '�TEVE � .I i��a�a �:�i�, �;�' , � AY�ATA M�! .'"a53'�1 � � F � ' REMARKS: , � _. . ._ _, _ i � ____- -- --- ___ �_--- _-_---- - --_--- --- __- - . _. - � ��� THE �.�a�R:���Gid�t� H�RE�'P �fiE�����.�T:� FE�`�i�:�:�I t:i1V T� �it�l:� Tt�� �Ef��. ��i�'F�lV'EP��i�T� ^1' �: �F'��:�F�Ea AAtd pC;�EE�:. TC+ D�:t 6�LL W�'1Fi� I�t �T�i I�T �:��'I�'L I fl��IC:� W I TF3 AL.L �i T�' i�'. ' � '� t��t��i�+� r:,�Ra I�I�i��E:�. f�D_.��1`ATE___iJ�_ P��IUI�E��3T�, �4.�1�.#��{��._�+��9� �;E.��iJ I RE�I�AIT:�. - -: - - �� � � + . � a:�:�-� APP CANTIPERMIT ATURE , ISSU BY: SIGNATI� E _ i � ,, - .a MINNEGASCO SERVICE INSTALLATION Map No. Natural Gas ❑ Propane Vapor ❑ Permit No. < Municipality ,�,t,y,.�-;� Minneapolis � OrderNo. _ �'-���`';��'s Folio No, Date Ordered �� �,� E No. ` - Customer's Name ;:�,,�-,� �� ��,� Tel. . �_-,...`���..�_e Installation Address � ; a,.,,.�� �� Zip � ` Lot,�,T.�._Block � Addition v _� "_M�- ` Method of Installation or Construction (including method of compaction and excavation) will be in accordance with procedures as described in Minnegasco Operations Manual,Section 500, "Excavating, Backfilling and Surtacing",the most recent edition on file with the permitting authority. Install: Service_T..Main Location ' Additional �nfo. Pressure Class Date Completed Foreman's Name To the (City Engineer _ (City Council (Village Council (Town Board The Minnesota Gas Company hereby requests permission to perform the work indicated above. - MINNESOTA GAS COMPANY ,��-:�-!'��,,w--.. ,�./ _ (Chief Engineer) �_ To the Minnesota Gas Company Permission is hereby granted the Mirinesota Gas Company to perform the work indicated above. of " ° Date '- ` . By- _;- . . - r - f,4uthorized Signature) Form 52 R 5/78