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MTU Installation Request Form
Date MARCH 7, 2007
Time 8:00 AM
Account Name SCOTT SYDE
Address 16231 NORTHWOOD RD NW
Account # 00172000
Meter size 5/8" C) 165' 5ffl 0
MeterS/N 77 () z- q~ Z ~
MTU # 0) Z '& 7 7/;3
Check the following:
Flow V Meter seal J
Main on J
Comments: LOCK BOX - RCB
JEFF, MATTHEW DANIELS 651-248-7330
Installed bv rP
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ACCOUNT #
ADDRESS / (, 2.3 )
OLD METER
LI-G>
Ser. No.
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NEW METER
Ser. No . / JOkey ~ 28 I
Reg.No. /
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Size ~ h< X
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Digits
Reading---ta$ z$JO j
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MIU Ser. No.
MIU Phone#
Bldg. Type":
RPZ Installed Yes
No
;
Service 'Size
(/\J '[lJo
7'7~
Port ,'1'"
2
~"l
'J
-1
,t
RPZ Ser. No.
. ''%
Type L
.'
lead_ copper~ron Pipe_
Ground Yes ~o_
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Comments:
Please keep this receipt for your rec~1 reading fro;Your old water meter
. will be used in determining your next regular bill.
If you have any questions or problems, please contact the Water Department during
normal workinghours;:thank you for your cooperation.
INSTALLATION .ACCEPTA~.L~.,4;A..:T~ ME~E~IRE IN PLACE..
OCCUPANTS SIGNAT~E ~/:./~~
DATE /0-/-0 'l.;;;s ... PHONE '-/'{"1- "~-u. I
From 90080 (4-93) ~opy 1 Customer Copy 2 WS Copy 3 & 4 WD
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