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Map No. __ <br />Municipality <br />MINNEGASCO SERVICE INSTALLATION <br />Natural Gas C Propane Vapor Permit No. <br />Qrnno Minneapolis O Order No. <br />Date Ordered 1 n-1 -7° <br />Customer's Name U^uid A Dot^cnroth TpI • <br />Installation Address ^22t. r.a«;cn C i rr 1 n 7ip <br />Lot 2m,AfMitinn Sprinq Park Add <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» <br />Additional Info. <br />Service Main Location <br />Pressure Class <br />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(I'own Board <br />The Minnesota Gas Company hereby requests permission to perform the work <br />indicated above. <br />MINNESOTA GAS COMPANY <br />z' I ' (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 />.> t 4------- <br />Date 1 <br />V.. <br />(Auttlof izfd Signature) <br />Form 52 R 5/78