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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas C -J Propane Vapor 0 Permit No. <br />Municipality Minneapolis E Order No. <br />Folio No. Date Ordered :;M; '>- E No. <br />Customer's Name - L « egb In Tel. 1 <br />nstallation Address f -1 . 1—)," r.r. ...j: III l!Ad - <br />lot Mock Addition s&-L�n�_1 <br />Zia <br />Method of Installation or Construction (including method of compaction <br />and excavation) will be in accordance with procedures as described in <br />Mi-inegasco Operations Manual, Section 500, "Excavating, Backfilling and <br />surfacing", the most recent edition on file with the permitting authority. <br />Install: Service Main Lur-il —i <br />Additional Info. <br />_.�.. Pressure Class <br />Vatc %'Umpitimu 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 />M <br />To the Minnesotd Gas Company <br />MINNESOTA GAS COMPANY <br />(Chief Engineer) <br />Permission is hereby granted the Minnesota Gas Company to perform the work <br />indicated dbove. <br />saw <br />of ...,,.; <br />Date <br />fAutt-oared Signature) <br />Form 52 R 5 78 <br />