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Rec'd in Street <br />■ i '4 <br />Mpls.(~l <br />Sub. <br />Map No^ <br />MINNEGASCO <br />SERVICE INSTALLATION <br />MUNICIPAL <br />PERMIT NO. <br />oRoao <br />S67 <br />Customer's Name <br />Oldf"! NewQ Bldg. <br />ORDER NO. JOZtf <br />E-NO. _ <br />Class I <br />Tel. <br />installation Address <br />Legal Description: Lot No. ' • 1 - - f' Block No._ <br />_____ • a t 'iur i j tit Addition. <br />4 <br />Contr’s Name Tel. <br />Contr's Address <br />Owner ’s Name Tel. <br />Owner ’s Address <br />CF/Hr. Taken ByDote Ordere d I0-15-7o Max. Demand ___ <br />Moin Auth. No.j __222__ Service Location: Right Q Left n Front f"] <br />Add’l Info. Secv Ik”; » •’I . <br />vt ' ■ ^ 4. 4 * <br />Date Completed Foreman’s Name <br />form 92*3R «/ 00