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Rec'd in Street MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />Mpls.n SERVICE INSTALLATION ORDER NO. ! 436 <br />Sub. cito ) E-NO. 330 <br />Map No. 521 Old[:) New❑ Bldg. Class 6 <br />Customer's Name Yrt Tel. <br />Installation Address 3670 W-11agn St JDff e u.►-,; hiy ,.'+,� <br />Legal Description: Lot No. 4 Block No. it <br />Addition <br />Contr's <br />Contr's <br />Owner's <br />Owner's <br />Name Tel. <br />Address ' <br />Nome--- Tel. <br />Address <br />Date Ordered Max. Demand CF/Hr. Taken By <br />Main Auth. No. Service Location: Right Left M Front <br />Add' I Info. :.1.5 ' Pb Qr_3" main 1 S' 17CII, ) MA L., ,R i 48 <br />1 F; <br />Date Completed Foreman's Name <br />To,the (City Engine�[[ xY <br />LL <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 />352 6 (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 />of <br />Date By <br />(Authorized Signature) <br />FORM 52-3R 6' 69 <br />