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• MINNEGASCO SERVICE INSTALLATION <br />Map No. 612 Natural Gas ❑ Propane Vapor ❑ Permit No. <br />Municipality 0ro-ia Minneapolis O Order No. 7j�8 <br />Folio No. Date Ordered 10-4--81 E No. 30 <br />Customer's Name l' i m C�' Cnnnor Tel. <br />Instaliation Address !105 Ferndale Koad North _ 1P <br />Lot 2-Block I Addition F i wn s. V i aw <br />Install: <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 />Service Main <br />Additional Info. <br />Pressure Class <br />uate Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Location <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 />Date <br />of <br />By <br />(Au h <br />ignature <br />t_ <br />Form 52 R 5/78 <br />