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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas ❑ Propane Vapor FJ Permit No. _ <br />Municipality Croro Minneapolis O Order No. 6089 <br />Folio No. Date Ordered �" "-' E No. 34 <br />lL <br />ustomer's Name A.W. LarIson Tel. <br />nstallation Address 122 Chevy Chase Drive Zip <br />ot Block i Additior H i I I away. Manor <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 <br />Additional Info <br />vats %.v►nulutuu <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />ru►e►nan 5 i)Iarne <br />Pressure Class <br />Location <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 />' of <br />Date L� i 6 -Z9 By <br />(Authorized Signature) <br />Foran 52 R 5'18 <br />