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r MINNEGASCO SERVICE INSTALLATION <br />Map No. - Natural Gas □ Propane Vapor □ Permit No. <br />Municipality C\rnni\ Minneapolis O Order No. 7^^^^ <br />^olio No. HatP Ordered A.» ) e No. yLL(^ <br />Customer's Name Janv»^. K , Rnwnrt;___________________________jgl ______ <br />Installation Address Pnln< p.n.-ir! <br />Lnfifl , 1 ng Block _____ Addition *^.prin ” Par!- <br />. Zip <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 />Prpcciirp <br />Date Completed -Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board M ■ <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 />. L <br />riato.26^J I, <br />jC’ 1 <br />(Auth^ri^ed Signature) <br />Form 52 H 5/70