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City of Fridley
Water Department
Address !'l d�J ��J2� 'So'("
Name �}%N4�. �R1�TTbiJ
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Date ����-�
Old Meter Number � i "rJ' j `�(�
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Old Meter Reading
Replacement No. �7� i3�� _
Replacement Reading � '
Replacement Make ���l7�
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