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Rec'd in Street <br />MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />MpIs.f_] SERVICE INSTALLATION ORDER NO. 1,264- <br />Sub. f::.�iiK) E-N0. — .44 <br />Map No__� Old[] New[:] Bldg. Class <br />Customer's Name Tel. <br />Installation Address__;..:,;;_, <br />Legal Description: Lot No. Block No. <br />Addition <br />Contr's Name Tel. <br />Contr's Address <br />Owner's Name_ __ Tel. <br />Owner's Address <br />Date Ordered Max. Demand CF/Hr. Taken By <br />Main Auth. No. Service Location: Right [] Left Front <br />Add'I Info. <br />., <br />f <br />Date Completed <br />To the (City Engineer .k)L <br />(City Council CALL <br />(Village Council <br />(Town Board <br />Foreman's Name <br />The Minnesota Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNESOTA GAS COMPANY <br />/' C <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 />0 <br />(Authorized Signature) <br />FORM 32.3R 6169 <br />