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MINNEGASCO SERVICE INSTALLATION <br />Map No. Natural Gas Cl Propane Vapor D Permit No. <br />Municipality (Irnn:-i _ Minneapolis O Order No. 4122 <br />Folio No. Date Ordered 10 C+ E No. ,. ) <br />Customer's Name T Emma s L C j, r r g Tel. <br />Installation Address 11 1 .h v�4 Ch.aso Dr Zip <br />Lot b Block I Addition <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 />Late Uomvletecl rvreman y wcrne <br />To the (City Engineer <br />(City Council <br />('tillage Council <br />(Town Board <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 />Date <br />Form 52 R 5'78 <br />(Authorited Signature) <br />