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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas ❑ Propane Vapor ❑ Permit No. <br />Municipality Orono Minneapolis El Order No. 3At_�Ll <br />Folio No. Date Ordered n—�,aQ _ E No. YULE, <br />Customer's Name M ii c k A 0 j 2 na 1 a Tel. <br />Installation Address 761 C u nnla t 121ar" Zip <br />Lot _.1.Q Block —1 Addition � .� a tez Aid <br />Method of Installation or Construction (including method of compaction <br />and excavation) will be in accoruance 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 <br />Additional Info. <br />Pressure Clas., <br />Location <br />Date Completed roreman s ivame <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 />Ly-ti <br />(Chief Engineer) <br />To the Minnesota Ga. Compan I <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />Da•e - .. <br />;.. of <br />By - <br />IAuthprited Signature) <br />Form 52 A 5/78 <br />