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MINNEGASCO SERVICE INSTALLATION
Map No. 601 Natural Gas ❑ Propane Vapor ❑ Permit No.
Municipality Mlnneapoliti _� _ -Yrder No. ;
Folio No. tepf E No. '
Owtonwr's Name Tel.
Install 'on Address Zip
Lot alock Addition
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, Back' and
Surfacing", the m it recent edition on file with the pp! -.—..I"' ty.
Install: Service Main Location
Additional Info.
Pressure Class
To the (City Engineer
(City Council
(Village Council
(Town Board
Minnsga&
To Minnegasco, Inc.
above.
t-oreman's Name
hereby requests permission to perform the work indicated
MINNEGASCO, INC.
Permission is hereby yra.-Aed Minrnagasco, Inc. to perform the work indicated
Date �-
rorm 52 R 5/78
By 11 1, f 1
(Au
awe)