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Rec ’d in Street <br />Mpis. <br />Sub. <br />Map No_j, <br />MINNEGASCO <br />SERVICE INSTALLATION <br />_____^OldQ NewQ] Bldg. <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. <br />E-NO. <br />Class <br />Customer ’s Name__________ <br />Installation Address_______ <br />Legal Description: Lot No. <br />Tel. <br />Block No. <br />Addition^ <br />Contr’s Name__ <br />Contr’s Address <br />Owner ’s Nome <br />Tel. <br />Tel. <br />Owner ’s Address_____________________ <br />Date Ordered _____• . Max. Demand <br />Main Auth. No. - " <br />Add’l Info. <br />CF/Hr. Taken By <br />Service Location: Right Q Left Q Front Q] <br />Date Completed Foreman’s Name <br />JU'To the (City Engineer .,, <br />{City Council <br />(Village Council <br />(Town Board <br />The Minnesota Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNESOTA GAS COMPANY <br />A O’ <br />(Chief Design Engineer) <br />To the Minnesota Gas Company <br />Permission is hereby granted the Minnesota Gas Company to perforhi <br />the work indicated above. <br />Date <br />(Authorized Signafu»o) <br />FORM 32-3R 6' 69