HomeMy WebLinkAbout1975-10-13 Notice of Gas Service InstallationRec' Street
MUNICIPAL
MINNEGASCO PERMIT NO.
MPIs.❑ SERVICE INSTALLATION ORDER NO.
Sub. _'. E-NO. i
Map No. ibb Old❑ New❑ Bldg. Class
Customer's Name. -,9; Tel.
Installation Address _ i045W—ter *p1?
Legal Description: Lot No. Block No.
Addition
Contr's Name
Contr's Address
Owner's Nome_
Owner's Address
Tel.
Tel.
Date Ordered Max. Demand CF/Hr. Taken By
Main Auth. No. Service Location: Right ❑ Left ❑ Front ❑
Add' I Info.
Date Completed Foreman's Name
To the (City Engineer XX
(City Council
(Village Council
(Town Board
The Minnesota Gas Company hereby requests permission to perform
the work indicated above.
MINNESOTA GAS COMPANY
(Chief Design Engineer)
To the Minnesota Gas Company
Permission is hereby granted the Minnesota Gas Company to perform
the work indicated above.
of
Date
(Authorized Signature)
FORM 52-3R 6 69