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City of Fridley
Water De_partment
Address �b a� ��.nr�� �q,$� �
Name_� r�� 1�o rd �� 9
Date I '� "�6
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Old Met�r Number ,
Old Meter Reading � �� �
Replacement No. �� 7��
3
Replacement Reading �
Replacement Make UG..�-�9�
Remarks: NDU�e. �e�
Signed