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I <br />MINNEGASCO SERVICE INSTALLATION <br />Map No. ' Natural bias O . Propane Vapor D Permit No. <br />Mu4cipalit* Minneapolis O Order No. <br />Folio No. Date Ordered E No. <br />Customer's Name Tel. <br />I nstal l ation Address , ,, ...v r Zip. <br />Lot Block Addition t.l <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 and <br />Surfacing", the most recent edition on file with the permitting authority. <br />Install: Service Main Location <br />Additional Info. <br />Pressure Class <br />Date Completed Foreman's Name <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 />7 (Chief Engineer) <br />To the Minnfsota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated above. <br />of <br />Date By <br />IAuthorited Signeture) <br />