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Recd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />Mpls.r� SERVICE INSTALLATION ORDER NO. -" <br />Sub. Jc:°!) E -NO. —� <br />Map No. OldQ NewF_j Bldg. Class <br />Customer's Name —Zr C%er LOs"tet'' _ Tel. <br />Installation Address • �a:i <c•� t+t.ta na"t <br />Legal Description: Lot No. Block No. <br />Contr's Name <br />Contr's Address <br />Owner's Name__ _ <br />Owner's Address <br />Date Ordered - 10 . Max. <br />Main Auth. No. <br />Add'I Info. -/I PE Sej:,1 <br />aril <br />Addition <br />Tel. <br />Tel. <br />Demand CF Hr. Taken By-- <br />Service <br />y_Service Loco -ion: Right [I Left 7 Front <br />2" Main 5` f.0 P J);&ine (tybrj is <br />Date Completed Foreman's Name <br />To the (City Engineer "lp1.I <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 />)_ I // (Chief Design Engineer) <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 />iAu+hunzed Signature) <br />FORM S7 -3R 6 69 <br />