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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas O Propane Vapor ❑ Permit No. <br />Municipality 0 ro no Minneapolis O Order No. 60%''j <br />Folio No. Date Ordered L-2-/` E No. 30 <br />lL <br />ustomer's Name ce -fay Hoouer Tel. <br />nstallation Address 12.% Chevy Chase Dr Zip <br />ot h_ Block I Addition Hili okay Ma no r <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 : <br />Additional Info. <br />Ser. ,ce —Main Location <br />Pressure Class <br />Ud[C I✓10111PIULUU FUIUITld11 J IVtlITIC <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 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 Orono <br />Date By <br />(Authorized Signature) <br />Form 52 R 5`78 <br />