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Rec'd in Street <br />MINNEGASCO <br />Mpls.F] SERVICE INSTALLATION <br />Sub. 0R0%0 <br />Map No. Old[] New[] Bldg. <br />Customer's ame <br />Installation Address _ <br />Legal Description: Lot Nc. Block No. <br />Contr's <br />Contr's <br />Owner's <br />Owner's <br />Name <br />Address <br />Name — <br />Address <br />MUNICIPAL <br />PERMIT NO. <br />ORDER N0. c—.�,.61" <br />E-NO. 4 <br />Class <br />Tel. <br />Tel. <br />Tel. <br />Additic+n <br />Date OrderedMax. Demand CF Hr. Taken By <br />Main Auth. No: Service Location: Right ❑ Left 7 Front <br />Add'I Info. .481t <br />ou ► tilt <br />Date Completed Foreman's Name _ <br />To the (City Engineer IX <br />(City Council CALL <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 />2 (Chief Design Engineer) <br />To the Mirieapolis Gas Company <br />Permission is hereby granted the Minneapolis Gas Company to perform <br />the work indicated above. <br />of <br />Date <br />(Authorized Signature) <br />FORM 52-3R 6i 69 <br />