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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas O Propane Vapor O Permit No. <br />Municipality Qrnao Minneapolis O Order No. 2135 <br />Folio No. Date Ordered 1+-1.T gg E No. �446 <br />[,Lot <br />ustomm er's Nae �. William 1401 s;6 Tel. <br />nstallation Address 1,144 CsT-t-1 BeT.-Road Zp <br />Block Addition <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 Mandbal, Section 500, "Excavating, Backfilling and <br />Surfacing", the most recent edition on file with the permitting authority. <br />Install: Service Main Location <br />Additional Info. <br />Pressure Class <br />uate c:om <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Foreman's Name <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 � - ' �' - � �By . ~�o�� <br />(Authorize Signature) <br />Form 52 R 5/78 <br />