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Rec'd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />Mp1s.0 SERVICE INSTALLATION ORDER NO. <br />Sub. E-NO. <br />Mop No. Old❑ Now❑ Bldg. Close , <br />Customer's Name _ _ Tel. <br />Installation Address <br />Legal Description: Lot No. Block No. <br />t „� Addition <br />Contr's Name Tol. <br />Contr's Address _ <br />Owner's <br />Owner's <br />Name Tel. <br />Address <br />Date Ordered Max. Demand i_ CF/Hr. Taken By <br />Main Auth. No. Service Location: Right 0 Left Front [] <br />Add' I Info. 44 „ ,- j <br />Date Completed Foreman's Name <br />To the (City Engineer <br />(City Council rA-U. r- Allk <br />(Village Council <br />(Town Board <br />The Minnesota Gas Company hereby request: permission to perform <br />the work indicated above. <br />MINNESOTA GAS COMPANY <br />(Chief Design En@ln»r) <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 />(Autheriser ws) <br />FORM :2.8I! W N <br />