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MINNEGASCO SERVICE INSTALLATION <br />Map No. <br />Natural Gas ❑ <br />Propane Vapor ❑ <br />Permit No, <br />Municipality 0 rono V <br />Minneapolis O <br />Order No. 3963 <br />Folio No. <br />Date <br />Ordered 7- 111'80 <br />E No. 7446 <br />Customer's Name <br />C ha r l e s Teeter <br />Tel.15 <br />Installation Address <br />� Forest Lake <br />" <br />Drive <br />lip <br />Lot 4 Block <br />2Ajdlition Fore-,r <br />Arms C nun t y C i t-ib <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 <br />Additional Info. <br />LJaic UUMPieieu <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Main Location <br />rureman s rvame <br />Pressure Class <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 __ .f'',?�i-}• � ��--� ,! �+�.�. <br />(Authorizt-d S nature) <br />Form 52 R 5/78 <br />