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Recd in Street <br />Mpls. <br />Sub. <br />MINNEGASCO <br />SERVICE INSTALLATION <br />Map No. Old [7]New ❑ Bldg. _ <br />Customer's Nome <br />Installation Address <br />Legal Description: Lot No. —Block No <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. <br />E -NO. <br />Class <br />Tel <br />ddition <br />Contr's Name Tel. <br />Contr's Address — -- <br />Owner's Nome _. Tel. <br />Owner's Address <br />Date Ordered Date Wanted Taken By <br />Main Auth. No. Max. Demand __CF/Hr. Svc. Loc: AQBC3C[] <br />Add'I Info. 1%i3' GuL� ::'er'.� a its --------- — <br />Dote Completed Foreman's Name <br />To the (City Engineer <br />(City Council <br />(Village Council <br />(Town Board <br />The Minneapolis Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNEAPOLIS <br />GAS COMPANY <br />(Asst. Chief Engr.) <br />To the Minneapolis Gas Company <br />Permission is hereby granted the Minneapolis Gas Company to perform <br />the work indicated above. <br />of <br />Date --_—_-- By <br />(Authorized Signature) <br />Form 52•3 1/67 <br />