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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas O Propane Vapor O Permit No. <br />Municipality -0 U n o Minneapolis D Order No. 3Wg0f, <br />Folio No. Date Ordered !s -3 {j -.Sj I E No. n <br />Customer's Name S t e i r k- r K n n n f-i m a n Tel. <br />Installation Address 2320 D p i n s :� n Zip. <br />Lot _1 Block I Addition "+u r --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 />foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Pressure Class <br />Location <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNN-ESOTAA;GAS COMPANY <br />(Chief Engineer) <br />1 o the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />(_� r of <br />Date By <br />(Authorized Signature) <br />Form 52 R 5/78 <br />