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city ot Friai�y� �
water Department
Address a�
Name �,.OU �
Date �j- ��-C.�(�,
Old Meter Number �� p���_
Old Meter Reading �C�1�j I�rpO
Replacement No.�'����6�
Replacement Reading �
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Reference No. 50�-o�-o3z�� Request For Service Report
City of Fridiey
Service Requested Install meter Date 6/16/06 Time 9:OOam
Public Works Water :
Department Division
Location of Service need 6221 �ce c��k nL
Owner or Agent of Property Ron Larson Phone: {H) 763-300-8313
Name of Citizen Phone: (H)
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Address '
Details Of Request Insrall water meter. Appt. set for Monday, June 19,2006 at 10:00 am
Request Taken By: Wendy
Department ��"'( �
Persan respansible far request �7�`° � ����� Title
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Date Cleared O���� Citizen notified; Yes: No