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MINNEGASCO SERVICE INSTALLATION <br />Map No. <br />Natural Gas E-1 <br />Propane Vapor ❑ <br />Permit No <br />Municipality Orono <br />Minneapolis <br />Order No <br />Folio No. <br />, <br />Date Ordered 3_1`_g0 <br />E No <br />s'omer's Name Ro <br />ert �u6iq-uske <br />Tel. <br />nstallation Address 1{L.; <br />1L1 <br />orest a e <br />r i veot <br />Block <br />Addition rarest <br />+'rn5 oust ry <br />u ; c?��n <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 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. ' +' -9 <br />(Auth9tiz�d Signature) <br />f <br />Form 52 R 5/78 <br />