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Recd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />MPIs.[J SERVICE INSTALLATION ORDER NO. <br />Sub. E -NO. <br />_Map No. - Old(—? N v[! Bldg. Class <br />Customer's Name A IV � _ Tel. <br />Installation Address . W4 <br />Legal Description: Lot No. Block No. <br />i s M-- A d d i t i o n <br />Contr's Name _ _ Tel. <br />Contr's Address <br />nwner's Name - - — ---- — I. <br />Owner's Address <br />Date Ordered Max. Demand CF Hr. Tarcen By _ <br />Main Auth. No._ Service Location: Right Left F Front <br />Add'I Info. ,► Pr nry ;�1 hatn t;LOS IEW1 n:' i s <br />Date Completed Foreman's Name <br />To the (City Engineer <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 />r <br />/ (Chief n^sign Engineer) <br />f <br />To the Minneapolis Gas Company <br />Permission is hereby granted the Minneapolis Gas Company to perfor <br />the work indicated above. <br />of <br />Date -- --- By -- <br />(Authorized Signature) <br />FORM 52-3R 6/69 <br />