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,� <br /> ,._, MINNEGASCO SERVICE INSTALLATION <br /> Map No. �`�' Natural Gas ❑ Propane Vapor ❑ Permit No. <br /> Municipality �"�i'" Minneapol's Order No. <br /> Folio No. Date Ordered ���3�� E No. <br /> Customer's Name Tel. <br /> Installation Address =`���� �'��t �1� k'��1 Zip <br /> Lot Slock Addition <br /> Method of Installation or Construc;ion (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 M in Location <br /> Additional Info. ��f'•P-' 'ri�: O� Sexvlee <br /> Pre zure 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 /> MINNEGASCO, INC. <br /> �jT��,.� � <br /> (Sr. Design Engineer):/ <br /> To the Minnesota Gas Company <br /> Permission is hereby granted the Minnesota Gas Company to perform the work <br /> indicated above. <br /> - }__ <br /> .-��. , ' <br /> _�� o f <br /> Date _� `�`�%� By � <br /> (Authorized Signaturel <br /> Form 52 R 5/78 <br />