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Rec'd in Street <br />MINNEGASCO <br />MUNICIPAL <br />PERMIT NO. <br />MpIS.n SERVICE INSTALLATION ORDER NO. <br />Sub. . t, E -NO. ZW <br />Map No. Old[] New❑ Bldg. Class <br />Customer's Name Tel. <br />Installation Address <br />w+. <br />Legal Description: Lot No. �-- Block No. <br />Addition <br />Contr's Name Tel. <br />Contr's Address <br />Owner's Name Tel. <br />Owner's Address __ _ <br />Date Ordered , f Max. Derrand CF Taken By <br />Main Auth. No. Service Location: Right Left C Front E] <br />A d d' I Info. <br />Date Completed _ Fore _ .._ <br />P mans Name <br />To the (City Enginee XX <br />(City Council <br />(V i' !age Council <br />(Town Board <br />The Minneapolis Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNEAPOLIS GAS COMPANY <br />(Chief Design Engineer) <br />To the Minneapolis Gas Company <br />Permission is hereby grunted the Minneapolis Gas Company to perform <br />the work indicated above. <br />Date <br />FORM tit-sR 6i Go <br />of <br />By <br />(Authorized Signature) <br />