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Rec'd in Street ► MUNICIPAL <br />Contr's <br />Name <br />Contr's <br />Address _ <br />Owner's <br />Name <br />Owner's <br />_ <br />Address <br />MINNEGASCO PERMIT NO. <br />Mpls.F] SERVICE INSTALLATION ORDER NO. <br />Sub. (A()N() E-1`10. <br />Map No. 366Old❑ New❑ Bldg. C ;s <br />Customer's Name _ _ Tel. — <br />Installation Address <br />Legal Description: Lot No. � _ Block No. <br />Addition <br />Tel. <br />Tel. <br />Date Ordered&2q.27 Max. Demand CF'Hr. Taken By <br />Main Auth. No. Service Loc. `ion: Right Left F] Front <br />Add'I Info._j1;8#' IE 5Gry i" Main 101 ALitte -966) SS <br />1. 101 <br />Date Completed <br />To the (City Engine xxx <br />(City CounciF.F,LL <br />(Village Council <br />(Town Board <br />Foreman's Name <br />The N' ineapolis Gas Company hereby requests permissio,i to perforrn <br />the work ind;,:ated above. <br />MINNEAPOLIS GAS COMPANY <br />(Chief Design Engineer) s �r <br />To the Minneapolis Gas Company <br />Permission is hereby granted the Minnecpolis Gas Company to perform <br />the work indicated above. <br />of <br />Date r "1 B <br />y '- <br />(Authorized Signature) <br />FORM 57-3p 6 69 <br />