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Rec'd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />MpIs.❑ SERVICE INSTALLATION ORDER NO. <br />Sub. ::, �R1i, E-NO. �_ <br />Map No. Old❑ New❑ Bldg. Class <br />Customer's Name Tel. <br />Installation Address r _ <br />Legal Description: Lot No. � Block No. <br />Addition <br />Contr's Name <br />Contr's Address <br />Owner's Name <br />Owner's Address <br />Tel. <br />Tel. <br />Date Ordered L,_,i` Max. Demand CF/Hr. Taken By <br />Main Auth. No. Service Location: Right ❑ Left ❑ Front ❑ <br />Add'I Info. <br />Ail it ' ' <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 (Chief Design Engineer) <br />3.4 <br />To the Minneapolis 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 52-314 6/ 69 <br />