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Rec'd in Street <br />MINNEGASCO <br />Mpls.❑ SERVICE INSTALLATION <br />Sub. f <br />MUNICIPAL <br />PERMIT NO. <br />ORDER NO. ' 15�4 <br />E-NO. <br />Map 'Jo. Old[] NewQ Bldg. Class <br />Customer's Name i ' Lty'x Tel. <br />Installation Address '�a '.•i�'.�itw <br />Legal Description: Lot No. Block No. <br />y Addition <br />Contr's Name <br />Tel. <br />Contr's Address <br />Owner's Name Tel. <br />Owner's Address <br />Date Ordered i Max. Demand W_ CF/Hr. Taken By • <br />Main Auth. No. Service Location: Right:0 Left ❑ Front ❑ <br />Add' I Info. f g" 1 .�, :_ � Gji s 1 t f `' _r <br />Date Completed <br />Foreman's Name <br />To the (City Engineer r <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 />(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 />, A t <br />B � -1 <br />Y <br />(Authorised Signature) <br />FORM 62-3R 6/ 69 <br />