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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas C7 Propane Vapor [ J Permit No <br />Municipality 0 ro,� r) Minneapolis El Order No <br />Folio No. Date Ordered Zz Z— L2 E No <br />Customer's Name Ralph C. Bagley Tel. <br />In staftation Address s+ 105 Ferndale Road West Zip <br />Lot A Block Addition R L S 44 j <br />Install <br />5146 <br />7, 46 <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 editiorvon file with the permitting authority. <br />Additional Info. <br />Date Completed <br />Service Main Location <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Foreman's Name <br />Pressure Class <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />i (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 147 <br />of _ <br />By <br />(Au thori <br />ature) <br />Form 52 R 5178 <br />