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MINNEGASCO SERVICE INSTALLATION <br />Map No. 6 h; Natural Gas LJ Propane Vapor 0 Permit No. <br />Municipality Minneapolis a Order No. '0403 <br />Folio No. Date Ordered 5` `- E No. <br />Custormr's Name Robert Roderick Tel. <br />+ Installation Address Zip <br />Dickey Lake DR Zip <br />Lot ' Noel, _ _ ._ 'Addition Rin rswood <br />i <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 ana <br />Surfaring", the most recent edition on file with the permitting authority. <br />Install: <br />Additional Info. <br />Service Main Location <br />Pressure Class <br />Date UompietiW roremar� s rramc <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Minnegasco Inc hereby requests permission to perform the work indicated <br />above. <br />To Minnegao0a, 14. <br />Dab <br />MINNEGASCO, INC. <br />(Superview ) <br />Permisswn is hereby granted Minnegasco. Inc. to perform the work indicated <br />z <br />-of <br />(Auttwized Srgnsturr) <br />Form 52 0 5/79 <br />