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MINNEGASCO SERVICE INSTALLATION <br />■ Natural Gas □ Propane Vapor H] Permit No. <br />Q -'ono Minneapolis LJ Order No. <br />__ Dati- Ordered S«»l ______ E No. <br />^itomer't Narne R.K. Ruthenbeck ____________________________Tel. <br />Installation Address Casco Point Road _______ Zip <br />Lot Block IQ7 Addition Sot Pari <br />Map No. _ <br />Municipality <br />Folio No__ <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 />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />f <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 />nf OraiiQ <br />Date <br />Form 52 B 6/78 <br />I..,--? a. <br />/ <br />lAulhoff/ed Stgnaturcli