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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas U Propane Vapor i J Permit No <br />Municipality Minneapolis E.1 Order No <br />Folio No. Date Ordered i t, E No <br />IL <br />ustomer's Name f humin s H- R u Y i I Tel. <br />nstallation Address Ili? Chp_y Chw p Dr i vi, Zip <br />ott i is Block _L_ Addition 141 1 1 riw i�g Mart! r <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 />Pressure Class <br />va c %'Um lumu r'uferTldll S IVdme <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <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 />Date <br />Form 5 a 8 <br />By <br />_ref <br />(Authorized Signature) <br />