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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas D Propane Vapor D Permit No. <br />Municipality �T^g.1�GQL�Q� Minneaptilis 0 Order No, <br />Folio No►' Date OrdeW`d 7 t E No, <br />Customer's Nanie Ken Schuh ze Tel. <br />Install ation�Q►ddress Gt,e vy GhE1se CPIVe Zip <br />Lot 1 G Block _!_. Addition )-(i 11 owry t,'&r,c.r <br />.• <br />l / V <br />10724 <br />�4 G <br />Method of Installation or Construction (including method of compaction <br />and excavation) will be in accordance Mth procedures as described in <br />Minnegasco Operations ManuA 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 />"OLU %,U111P1CLUU _ rureman s ivame <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 />Date .. `By <br />- <br />Form 52 R 5178 <br />r' -of <br />(AuthWIzed Signature) <br />