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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas a Propane Vapor CJ Permit No. <br />Municipality Minneapolis O Order No. _ 99,3 <br />Folio No. Date Ordered 2 21 E No. 30 <br />ICustomer's Name r ry Coast r Tel. <br />Installation Address �L18LLFar V PW Ammer,►►e Zip <br />Lot �— Block _2._ Addition Fa ry i eW _._ <br />Method of Installation or Construction (including method of compaction <br />and excak,ation) will be in accordance with procedures as described in <br />Minnegasco Operation-, 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 />uate wrn 1eteu rurernan s NdMe <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 />(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 <br />(Authoriz Si lure) <br />/ <br />Form 52 8 5/ /8 <br />