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MINNEGASCO SERVICE INSTALLATION <br />Map No, Natural Gas ❑ Propane Japor O Permit No. <br />Municipality Minneapolis O Order No. 23844 <br />Folio No. Date Ordered A-20-94 E No. 30 <br />Customer's Name .7myeg F Harsort Tel. j <br />Installatim Address 64 D kr,t n AvE-- Zip <br />Lot 6 Block Addition lohmaca- Pi, rrangL-A,ig- I <br />Method of Installation or Construction (including method of compaction <br />and excavation) will be in accordance with prxedures as described in <br />Minnegasco Operations Manual, Section 500, "Excavating, Rackfiiling 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 />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />The Minnesota Gas Compary hereby requests permission to perform the work <br />indicated above. <br />MINNE.�GAlS�C�O,, ING.f <br />_ ;PR <br />/"/ Glz xs , <br />(Sr. Deaipn Engkteer) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />g�� <br />Date �i ey Wb 1-5 <br />(Au Signature) <br />Form 52 R 5 18 <br />4 <br />