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HomeMy WebLinkAbout1981-07-20 Notice of Gas Service InstallationMINNEGASCO SERVICE INSTALLATION -■ Natural Gas □ Propjne Vapor O Permit No----------— Municipality ____________________ Minneapolis O Order No— Folio No_________________________D'ite Ordr" Prill----------- E No— Customer's Name LilHJ—tq_n-----------------------------------------------------jel. ---------- Installation Address ^ I P- iiir*■ ----------------------------------------------- Zip ---------- Lot Block _____ AHHitir^n JohfV-. t Of.s Rcof rcnq^iiPen t_________________ Map No. Method of Installation or Construction (including method of compaction and excavation) will be in accordance with procedures as described in Minnegasco Operations Manual, Section 500, "Excavating, Backfilling and Surfacing", the most recent edition on file with the permitting authority. Install:_______ Additional Info. Service Main Location .Pressure Class Date Completed Foreman's Name To the (City Engineer (City Council (Village Council (Town Board The Minnesota Gas Company hereby requests permission to perform the work indicated above. MINNESOTA GAS COMPANY Qr/^l X ■(Chief Engineer) To the Minnesota Gas Company Permission is hereby granted the Minnesota Gas Company to perform the work indicated above. ^ y' / /L Date -7.-------.-i (Authorised Signature) Form 52 R 5/78