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; <br /> MINNEGASCO SERVICE INSTALLATION <br /> Map No. Natural Cias � Pra�ane Vapor ❑ Permit No. <br /> Municipality Minneapolis � Order No. <br /> Folio No. Date Ordered E No. <br /> Customer's Name Tel. <br /> Installation Address Zip <br /> Lot Block Addition � <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 Com leted Foreman's Name <br /> To the (City Engineer <br /> (City Council <br /> (Village Council <br /> (Town Board <br /> Minnegasco Inc. hereby requests permission to perform the work indicated <br /> above. <br /> MINNEGASCO, INC. <br /> �/� /, `�� <br /> , <br /> � �=Gf/�i�T��sC/,�C-�r'/� <br /> (Supervisor) <br /> To Minnegasco, Inc. <br /> Permission is hereby granted Minnegasco, Inc.to perform the work indicated <br /> above. <br /> of <br /> Date By <br /> (Authorized Signature) <br /> Form 52 R 5/78 <br />