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� . <br /> MINNEGASCO SERVICE INSTALLATION <br /> Map No. Natural Gas ❑ Propane Vapor ❑ Permit No. <br /> Municipality Minneapolis 0 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 /> •� ■ r+.,�a d�� �>:i° ��1 .. �_$�� 1'�5..1.. I.,'-���'�.�` °�:=' <br /> Install. ''{` £i�`� Service -` °�—Main Location <br /> Additional I nfo. � <br /> � Pressure Class T� <br /> v �._"t':;;_i_:_; <br /> Date Completed Forem�n'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 /> /'- /"� :%�F.,,- '�.. <br /> (Sr. Design Engineer)`/ <br /> To Minnegasco, Inc. <br /> Permission is hereby granted Minnegasco„kmc.�o perform the wor .i�dicated <br /> above. �� � <br /> i l� ,i��-%` <br /> of <br /> ,': . � ' � f - ' <br /> „ 'r <br /> Date By ' � <br /> (Authorized Signature) <br /> Form 52 R 5/78 <br />