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Recd in Street <br />MINNEGASCO <br />MUNICIPAL <br />PERMIT NO. <br />Mpls.❑ SERVICE INSTALLATION ORDER NO. <br />Sub. ORONO E -NO. <br />Map No... ,Old❑ New❑ Bldg. Class <br />Customers Name ;�: °_.,! R _ } 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 />Date r rdered Max. Demand CF/Hr- Taken By <br />Main Auth. No. Service Location: Right ❑ Left ❑ Front <br />Add'I Info. <br />Date Completed <br />To the (City Engineer `' s. <br />(City Council FALL <br />(Village Council <br />(Town Board <br />Foreman's Name <br />The Minnesota Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNESOTA GAS COMPANY <br />(Chief Design Engineer) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perform <br />the work indicated above. <br />Date <br />FORM 's2 -3R 6 69 <br />of <br />(Authorized Signature) <br />