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Map No. <br />Q rana <br />MINNEGASCO SERVICE INSTALLATION <br />Natural Gas □ Propane Vapor □ Permit No. <br />Folio No Hat** nrrlpr»H F No 7lxli A <br />Customer's Name Rr Mr;-7 1 Tol ■ <br />Installation Address ?8n7 Pnlnf RriAfl _____ 7ip _ <br />Lo»2?-12i«ock A<Mi«inn $prIngPark <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 Location <br />Pressure Class <br />Foreman's Name <br />To the (City Engineer J <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 ■n <br />— <br />By <br />, / <br />■ A t ‘ \ ^ ) <br />(Authori/ed Signature) <br />form 52 R 5/78