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MINNEGASCO SERVICE INSTALLATION <br />Map No. N.,turdl Sas Pi pane Vapor E-1 Permit No <br />Municipality -- - Mi neapolis C Order NO <br />Folio No. Date Ord red ','2- - E No <br />Customer's Name Tel <br />Installation Address _ Zip <br />Lot Block Addition <br />Method of installation or Construction (including r„ethod of compaction <br />and excavationI will be in accordance with procedures as described in <br />Minnegasco Operations Manual, Section 500. "Excavating, Backfilling and <br />Surfacing", the most recent edition cn file with the permitt-ng author rty. <br />Install: Service Main L0 ,.dnon <br />Additional Info <br />Pressure Class <br />Date Completed Foreman's Name 1 <br />To the (City Engineer I <br />(City Council <br />(Village Council <br />0 own Board <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />r "r <br />1-z ti L <br />i lChief Engineer) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />of <br />Doti- By <br />(Authut ed gnathirel <br />