Permit- MN Gas Co ( Replacement Gas Line)4
Permit No
Name of Party or Organization performing work
Address 733 Marquette Avenue
CITY OF ttur1t1IV5
JOb 14-381 1982 MGC #65
APPLICATION FOR PERMIT FOR INSTALLATION OF UTILITIES
OR FOR PLACING UNDERGROUND CONSTRUCTION
MINNESOTA GAS COMPANY
1. Nature of Work Installation of gas ###44/main
Type of Surface to be Disturbed
(Check type) (Gravel) (Bituminous) (Concrete) (Boulevard)
2. Location As shown on enclosed drawing.
Street, Avenue and House number
(Additional information attached when necessary)
3. Size and kind of pipe, conduit or cable
2" AA
Depth from Surface 2.5 feet
Dimensions of Excavation 18" x 420'±
4. Method of Installation or Construction (including method of compaction and excavation)
In accordance with procedures as described in Minnegasco Distribution Department Operations Manual,
Section 500, "Excavating, Backfilling and Surfacing", the most recent edition on file with the permitting authority
Machine Excavation: Yes X No
5. Work to start within Fall, 1982 days and completed with Open
6. Will detouring of traffic be necessary? No If so, describe rerouting:
For
Telephone No
Minnesota Gas Company
days thereafter.
Signed By
Dated November 9, 82
The date when work is completed must be reported to the person designated by municipality.
AUTHORIZATION OF PERMIT
.37 3 43 -7 02.3
Upon payment of permit fee in the amount of 10. and in consideration of the agreement to comply in all
respects with the Street or Alley excavation ordinances and regulations applicable covering such operations, permission is here-
by granted for the work to be done as described in the above application, said work to be "done in accordance with special pre-
cautions required, as hereby stated:
It is expressly understood that this permit is conditioned upon replacement or restoration of the road surface to its proper
condition in accordance with the appropriate rules and regulations. It is further understood that this permit is subject to re-
vocation within ten (10) days of receipt of copy of application by the County Engineer when the permit is for work on a
County Road.
APPROVED
DATE
All requirements shown on reverse side to be complied with.
White copy to applicant, yellow to Municipality Engineer, blue to Municipality Street Superintendent.
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RELEASE FOR CONSTR.
Date
By
COMPLETED
Date
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Sic To 22-1 Nor o 2.D
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Mai will lie 2 Ft. 6" below existing street gKadf
Pipe Req`d.
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Totai Pi e 42.0't Est. Cest
Foreign Structures Permits Required
Water va 6 Co. Rd.
San. Sew, yES St Hwy.
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Telephone CALL: c HE N °Pio til •5
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By
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Designed
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