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Map No.b37 <br />Municipality <br />Folio No. __ <br />Kft <br />MINNEGASCO SERVICE INSTALLATION <br />— Natural Gas □ Propane Vapor Q Permit No. <br />Minneaptrti _ P Order No. <br />Customer's Name T7 Un 1 ; > .,M ;Date Ordered <br />Address J ^ ’ I L.' I 'J < I y ‘ V <br />Blocic Addition Li! <br />E No. <br />-Tel. <br />. Zip <br />“W <br />Method of ln-;tallation or Construction (including method of compaction <br />»d excavation) will be *n accordance with procedures as described in <br />MinnegasM Operations Manual. Section 500, "Excavating, Backfilling and <br />Sur acing , the most recent edition on file with the permitting authority. <br />Install: <br />i Additional Info. <br />.Service Main Location <br />To the (City Engineer <br />(City Cduncil <br />(Village Council <br />(Town Board <br />above.Minnegasco Inc. hereby requests permission to perform the work indicated <br />MINNEGASCO. INC. <br />(SupTvItor) <br />To Minnegasco, Inc. <br />above. <br />Permission is hereby granted Minnegasco. Inc. to perform the work indicated <br />. < C ^ <br />Date r <br />- { <br />(Authorized Signaturv) <br />Form 62 R 5/78 <br />\'