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MINNEGASCO SERVICE INSTALLATION <br />Map No. ■ Natural Gas □ Propane Vapor □ Permit No ________ <br />Municipality 0Minneapolis fD Order No. 1337 <br />Folio No. HatP Ordered__ L_i e No___2^ <br />Customer's Name I'l-./i.i y-.ri.-'-- TpI _ <br />Installation Address Zip __ <br />Ut U? Bock Addition Park <br />r. <br />Method of Installation or Construction (including meihod 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 />Date Completed Foreman's Name <br />If <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 panted the Minrtesota Gas Ckimpany to perform the work <br />indicated above. <br />Date <br />r'i 7. <br />JUof <br />y <br />:-*T^7 M Z4 ^i t fTL i* " ^ <br /><AuttiOfi/«d Sionafur«l <br />form 62 R 5//•