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Recd in Street <br />MP I s .❑ <br />Sub. ). ::! <br />MINNEGASCO <br />S-RVICE INSTALLATION <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. <br />E -NO. <br />Map No. ,11� Old ❑ New f Bldg. Class <br />Customer's Name Tel. <br />Installation Address <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 />Dote Ordered Max. Demand CF; Nr. Taken By <br />Main Auth. No. _ " Service Location; Right ❑ Left ❑ Front ❑ <br />Add' I Info. {. i <br />+j* <br />Dote Completed Foreman's Name <br />To the (City Engineer <br />f <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 GAS COMPANY <br />(Chief Design Envin*er) <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 <br />(Authorized Signature) <br />FORM $P -SR A 0s9 <br />