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Recd in Street <br />MUNICIPAL <br />MINNEGASCO <br />PERMIT NO. <br />Mpls.❑ <br />SERVICE INSTALLATION <br />ORDER NO. <br />Sub. <br />E -NO. <br />_ Map No. i <br />Old❑ New❑ Bldg. <br />Class e <br />Customer's Name <br />, ; f-;Inklai <br />Tel. <br />Installation Address <br />p is `,4x J I - <br />Leqal Description: Lot <br />No. i Block No. <br />Addition_ <br />Contr's Name <br />Tel. <br />Contr's Address <br />Owner's Name <br />Tel. <br />Owner', Address <br />Date Ordered, i.-, �. -- <br />Max. Demand CF,'Hr. <br />Take,i By <br />Main Auth. No. _. <br />Service Location: <br />Right ❑ Left [] Front ❑ <br />Add' I Info. r- <br />Date Completed <br />Foreman's Name <br />To the (City Engineer <br />3� <br />(City Council <br />(Village Council <br />(Town Board <br />The Minneapolis Gas Company hereby requests permission to perform <br />the work indicated above. <br />MINNEAPOLIS GAS COMPANY <br />(Chief Design Engineer) <br />To the Minneapolis Gas Company <br />Permission is hereby granted the Minneapolis Gas Company to perform <br />the work indicated above. <br />of <br />Date <br />FORM'S? -3R 6 69 <br />By -. <br />(Authorized Signotwe) <br />