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Date �� " � `'6 t�
Old Meter Number / �.3 d�
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Replacement No. � ,� �"�)��j /
Replacement Reading �
Replacement Make `J�a.��..c�+�
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Replacement ERT#
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City of Fridley
Water DeQartment
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Name `� ,' Qi
Date �'Z�`���
Old Meter Number ����(y��
Old Meter Readin � 2 0
Replacement No. o��
Replacement Reading
Replacement Make /� `
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ERT# ��-/ �J��?S��
Replacement ERT#
Remarks: 5`�' Y��-
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� Request for Service Report
City of Fridley
R eference N o: 601-11-3001 D ate: 04/22111
Requesk Type= Turn waker oFflon Entered By: 1Nendy Hiatt
Department: Water Citizen Name: Fady Dow
Address: $1d0 RUTH CIR NE Callback Phone: 612-860-2222
Scheduled Date= Property Owner:
Location Details: Homeowner states water is spraying out of Requesk Dekails= Shut water oFF
pipe near ground. Told him we would shut
waker off but he will need to get permit for
repair before it is turned back on.
x'xxBILL""
Action Taken:
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Responsible Persorr � '� �������
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Appro�er:
Completion Dake: � Citizen Notified
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