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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas ❑ Propane Vapor ❑ Permit No. <br />Municipality 0 rono Minneapolis Cl Order No. 3878 <br />Folio No. _Date Ordered 6-21440 E No. 7446 <br />I' Customer': Name Herbert. Olson Tel. <br />Installation Address9 > Forest Arms Lane Zip <br />Lot 3 Mock 2 Addition Forest Arms C C Add <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 edi+ion on file with the permitting authority. <br />Install: Service Main Location <br />Additional Info. <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 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 />(Aut ized ignsturel <br />Form 62 R 5/7e <br />