Meter Swap �
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Water Department
Address '��j�a-��/',�e�/`�" (jF
Name ^
Date �I'7—r�S' P�
Old l�ieter Number �3 �j L/�(�
Old Meter Readin
Replacement No. ��`T ��3 S 3
Replacement Reading (�
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ERT# �—�a-(o7`� $r
Replacement ERT#
Remarks: ���'{
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Signed��.�( � tF.
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