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WINNEGASCO SERVICE INSTALLATION <br />Map No. SR7 Natural Gas 0 Propane Vapor ❑ Permit No. <br />Municipality O&Q-0 Minneapolis E] Order No.-SL9 <br />Folio No.. Date Ordered, 1 A-111 _7Q E No. 3n...,, <br />Customer's Name M4 nnpti i n Tel. <br />Installation Address 7LanRBotdt»r Park Rand Zip <br />Lot --Mock Addition <br />Method of. Installation or Construction (including method of compaction <br />and excavation) will be in accordance with procedures as described in <br />Minnegasco Operations Manual, Section 500, "Excavating, Backfilling and <br />Surfacing", the most recent edition on file with the permitting authority. <br />Install: Service Main Location <br />Additional Info. —gap, MCC =X4C,0 -- - - <br />i <br />Pressure Class <br />Date <br />Fo <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />(Chief Engineer) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />Date <br />r <br />Form 52 R 5178 <br />rt <br />