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✓ City of Fridley „
Water Department ���� ..,��3 J
Address���� ��J`v�� N
Name ����, l,.���;l�,N1k1.)
Date ��-�-�
Old Meter Number ��c7�,��i�
Old Meter Reading ��� t�� ����Q� �
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Replacement No.��� "�aD�(
Replacement Reading
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Rep�acement Make �.
ERT# 5
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Replacement ERT#
Remarks: �{ �'"
Signed
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