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Rte'd in Street <br />Mpit. <br />Sub. <br />Map No. <br />MINNEGASCO <br />SERVICE INSTALLATION <br />Customer’s Nome <br />Installation Address ______ <br />Legal Description: Lot No. <br />PldQ NewQ Bldg. <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. <br />E-NO. <br />Class <br />Tel. <br />Block No. <br />Contr's Name___ <br />Contr's Address <br />Owner ’s Nome__ <br />Owner ’s Address <br />Date Ordered ____ <br />Moin Auth. No. <br />Add'I Info. <br />Addition^ <br />Tel. <br />Tel. <br />Max. Demand CF/Hr. Token By <br />Service Location: Right Q Left Q Front Q <br />iL, <br />Dote Completed Foremon ’s Nome <br />To the (City Engineer XI <br />(City Council ‘LL <br />(Village Council <br />(Town Board <br />CAUL <br />The Minnesota Gas Company hereby requests permission to perform <br />thi work indicated above. <br />MINNESOTA GAS COMPANY <br />C'k/\y\lJyK' <br />To tfnt Minnesota Gas Company <br />Perminion is hereby granted the MInnaota Gii Comp»iy to per form <br />ttw work indicafed above. <br />^ t. <br />Detei