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Rec'd in Street <br />MINNEGASCO <br />Mpls.❑ SERVICE INSTALLATION <br />Sub. �' <br />Map No. Old ❑ Now❑ Bldg. <br />Customer's Nome - <br />Installation Address <br />Legal Description: Lot No. =_T_ Block No. <br />Contr's <br />Contr's <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. <br />E-NO. <br />Class <br />e 9611" <br />Addition J <br />Name Tel. <br />Address <br />Owner's Name_ Tel. <br />Owner's Address <br />Dote Ordered Max. Demand CF/Hr. Taken By <br />Main Auth. No Service Location: Right ❑ Left ❑ Front ❑ <br />Add' 1 Info. %$Tra sery 1 _j s te,ei Planet L 967 <br />k- <br />Date Completed Foreman's Name <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 above. <br />MINNESOTA GAS COMPANY <br />6 (Chief oesign'EniginMr) <br />To the Minnesota Gas Company <br />Permission is hereby grw, , ted the Minnesota Gas Company to perform <br />the work indicated above. <br />Date <br />of <br />By <br />(AuHarizer 619nowe) <br />FORM 52-3R 5/ M <br />