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f-)0: MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas ;__) Propane Vapor C7 Permit No <br />Municipality ( 1J Minneapoli�`�_[�� Ordt.- No <br />Folio No. HaM Date Ordered r No <br />lIot <br />ustomer's Name y <br />_Tel . <br />nstallat`on AddressZip Block Addition ' <br />Method of Installation -)r 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 mos'_ recent edition on file with the permitting authority. <br />Install <br />Additional Info <br />Service --Main <br />Pressure Class <br />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />Location <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 />of <br />Date r'! J .: �_ BY ,' `z <br />(Authory2ed Signature) <br />Form 52 R 5 78 <br />