HomeMy WebLinkAbout1983-Emergency repair/replacement/mechancial MINNEGASCO SERVICE INSTALLATION �
Map No. . Natural Gas ❑ Propane Vapor C7 Permit No.
Municipality Minneapolis � Order No.
Folio No. Date Ordered E No.
Customer's Name Tel.
Installation Address Zip
Lot Block Addition
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
Surfacing",the most recent edition on file with the permitting authority.
Install: Service Main Location
Additional Info.
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
I�/InIN�Gy�A���e'INC. i
/- ' �I�"(�.v'.�A
/'
(Sr. Design Engineer):./
i ie ngineer
To the Minnesota Gas Company
Permission is hereby granted the Minnesota Gas Company to perform the work
indicated above.
of
Date By
(Authorized Signature)
Form 52 R 5/78
�
MINNESOTA GAS CO.MAINTENANCE ORDER NO.
O MAIN O SERVICE PAV.CUT NO. LEAK RPT.NO.
DATE MUNIC. RESP.ACCT.NO.
FPC-or-E NO.
LOCATION:
NATURE OF WORK
FOREIGN STRUCTURES PRESS. CL. NEW SURFACE DISTURBED
Tele 0 1 Q A TAP 0 Road Mix Bituminous O Dirt
Elec � 2 � C $IZE O Hot Mix Bituminous � Gravel
� 5 � E O Portland Cement Concrete O Oiled Earth
Light/Traf.Cable � 6 Q F
O 8 O K � Roadway � Blvd. O Walk � Alley
Other Size Disturbed
PIPE LENGTH O Same Ft. Longer Ft.Shorter Ft. Abandoned
SERVICE TAP MEASUREMENT
DATESTARTED COMPLETED FOREMAN
TRUCK NO. TOWN NO. FOREMANS P.R.NO.
To the (City Engineer
(City Council
(Village Council
(Town Board
The undersigned hereby requests permission to perform the work
indicated above.
MINNEGASCO, INC. � ��� ���� � � i
�J r�y,��,,�v--'r/'
/'��
�:
(Sr. Design Engineer)'.i
To the Minnesota Gas Company
Permission is hereby granted the Minnesota Gas Company to perform
the work indicated above.
of
Date By
(Authorized Signature)
FORM 45A R3/78