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Rec'd in Street <br />Mpls.❑ <br />Sub. 0--WHO <br />MUNICIPAL <br />MINNEGASCO PERMIT NO. <br />SERVICE INSTALLATION ORDER NO. <br />E-NO. <br />Map No. S393 Old❑ New❑ Bldg. Class <br />Customer's Name ,tl�, Tel. <br />Installation Address�i;—t„��ai:v�.:ti <br />Legal Description: Lot No. ,-4-4.�i Block No. <br />Addition <br />Contr's Name Tel. <br />Centr'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' l Info. <br />Dote Completed <br />-'To the (City Engineer XX <br />(City council ;ALL <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 />(chief Design Engine►) <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 92-Sm dr" <br />