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Map No. __ <br />Municipality <br />Folio No___ <br />MINNEGASCO SERVICE INSTALLATION <br />_____Natural Gas O Propane Vapor □ Permit No.. <br />_Qa.Qt:(j Minneapolis □ Order No. <br />Customer's Name . <br />Installation Address 2260 <br />Lo4^^oJ —Block ______Addition <br />______________Date Ordered j-’ ^ E No. in <br />P'lar^ Tmi ______________ <br />------------------------Zip-------------------P i <br />T 7 { 1 1 e. .f U » 1 <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 SOO, ''Excavating, Backfilling and <br />Surfacing", the most recent edition on file with the permitting authority. <br />Install: „ ,. <br />Additional Info. <br />.Service..Location <br />.Pressure Cla <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 Enginetr) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />/-' J . . nf <br />/ <br />7 <br />' - (Autborind Signaturil <br />Form 52 R 5/78