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Map No. <br />Municipality <br />MINNEGASCO SERVICE INSTALLATION <br />__ Natural Gas CD Propane Vapor CD Permit No. <br />Minnpanniic I I CirMar <br />Customer's Name , ,Ken Hartwell TpI <br />Installation Address 2639 Casco Pt Rd Tip <br />Lot LLZ iiiMk Spring Pk <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. <br />Pressure Class <br />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />The Minnesota Gas Company hereby repuests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />(Chief Engineer) <br />To the Minnesota Gas Company f # <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />r!! f:v Af Orcr. n <br />t <br />(Authorized Signature) <br />/ <br />Form 62 H 6/71