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f� <br />Map No <br />MINNEGASCO SERVICE INSTALLATION <br />Natural Gas ❑ Propane Vapor ❑ Permit No. <br />Municipality n ran Minneapolis D Order No. -3��- <br />Folio No. Date Ordered E No. 4jj j. c <br />1Customer's Name = on r �� A - M .c c Tel. <br />Installation Address 3 )3 t 3 j �;:—t2o�d Zip <br />Lot _ i 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 Manual, 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 />vaLC VuIpplumu ruieMdn s Name <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 />1 ��4 d, &I -- IL <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 `' t <br />be <br />of - <br />By � 1 <br />(Authorized Signature) <br />Form 52 R 5/78 <br />