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Map No. ___________ <br />Municipality Orono <br />Folio No. <br />MINNEGASCO SERVICE INSTALLATION <br />Natural Gas O Propane Vapor Q Permit No _______ <br />Minneapolis O Order No. 78S4 <br />Customer's Name A.V/, Schorven <br />Date Ordered 1 I -80 <br />Installation Address 2649 Casco Point Road <br />Lot —LlS.Block_____ AHHitinw spring Park <br />E Nn 7446 <br />Tel. _____ <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: ____ <br />Additional Info. <br />Service Main <br />Pressure Class <br />Date Completed Foreman's Name <br />Location <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 />6'ir.X <br />n... <br />4-A <br />(Authorised ^ignatifre) <br />Form 52 R 5/78