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City of Fridley
Water Deparhnent
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Name �p�.�y �,�Q�
Date__�� .�� —�
Old Meter Number �b ��Q .3 C� ..7
Old Meter Reading � T ��
Replacement No. � � �����
Replacement Reading �
Replacement Make ��r y-t,v
ERT# ��� T(p,�� l
Replacement ERT#
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Remarks: ��'J� �'���
Signed � �,"
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