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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas O Propane Vapor ❑ Permit No <br />Municipality rono Minneapolis O Order No <br />Folio No. Date Ordered E No <br />IL <br />stomer's Name Clitford. Ashmun Tel. <br />nstallation Address _117 Chevy Chase Drive Zip <br />ot , Block _ I Addition H i 1 I oway Plano r <br />X082 <br />�0 <br />Method of Installation or Construction (including method of compaction <br />and e: (cavation) 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 <br />Additional Info. <br />LJate %.urnUieieu <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Main <br />rureman s ivame <br />Pressure Class <br />Location <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />L y Z.: t <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 />of 1 <br />Date 10-9-79 By <br />(Authorized Signature) <br />Form 52 R 5'78 <br />