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Rec'd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />Mpls.❑ SERVICE INSTALLATION ORDER NO.. <br />Sub. E-NO. <br />Map No. _ Old[] Now[:] Bldg. Class <br />r Customer's Name Tel. <br />Installation Address��_„�,1,,,�,,,,� <br />Legal Description: Lot Igo. Block No. <br />Addition <br />Contr's Nome Tel. <br />Contr's Address <br />Owner's Name_ Tel. <br />Owner's Address <br />Date Ordered, Max. Demand C F/Hr. Taken By <br />Main Auth. No. Service Location: Right ❑ Left ❑ Front ❑ <br />Add' I Info. t. ? 4 Y <br />Date Completed <br />Foreman's Nome <br />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 shave. <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 />of <br />By <br />(Authorised Signature) <br />FORM 52-3R e/" <br />