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MINNEGASCO SERVICE INSTALLAT.. <br />Map No. Natural Gas 0 Propane Vapor 0 Permit ojo. <br />Municipality 0 r-on 7 Minneapolis 0 Order No. 7865 <br />Folio No. Date Ordered 8-2?- 80 E No. 7446 <br />Customer's Name J i �A i e Nu l t z Tel. <br />Installation Address 33�9 Crystal Bay Road Zip <br />Lot '3 Block Addition Wallace Add 1.0 14tka Beach <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 />uate Lom <br />Service Main Location <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Pressure Class <br />Foreman's Name _ <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 />_y <br />of ' _ell - <br />Date `i i '` � � By ~�� 'L.�vtJt..� � ��;� '•� �' _� <br />(Authorized Signature) <br />Form 52 R 5/78 <br />