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Meter Swap ��;�,�-�� ; �,- � �J 7�� INSTALLATION � ��' AUTOMATIC METER READER FRIDLEY Address � � — ��+��'�7 Name � I� ��`�"�.�I�•— ��R�'�E� C� � Date� `' — � "�`v� Old Meter Number � � U o�y� Old Meter Readi � J �d Replacement No. �� Y � : Replaceme�t Reading� Replacement Make ��'�E�� ERT# ��I � ( ` � Replacement ERT# Remarlcs, w��Z�� `�S� c.��c,�� Signed: �� €��.�sf fa�r�t�riae F�� i�y a�f Fr�d�y , , ��t�� a�-t�� : �t.r��r�trt� Tj�e_ T�w,a�-atflo� 8�: _ Wa� (�t'�a�_ �ie tii� Ad�: 51 �TH 1AtA1F� Ca�C: . S�d tl�: ?11l�913��F lwM�� t�pedjr{�wrrar_ t�[�: #��e p��aici�ca�af p�ap��r �#ec��eat Elef�: Te�aI��iar�epar_ �a�s _ " h�h� �er pu! �red#ad�raw p�p�s a� p�be�s+e wai��d t��Ic ad�re+�e a�e le�cs_ c�. .... Ai�are Ta�tr ��vz o�- ��-C� �� ,�r�v�--� �1��`� �I.-� 1 NS�� l��CZ �� .� � �3�d a y� �� -- d-��o�o �� - �� _ �� - � � �c� -- �� _ �__��^ _._________ _______ � �. � �--,� � :��__ ��__._�.__..�_._�� City of Fridley _ r Water Department � 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe hereby authorize the City af Fridley and/or its employees to do what is necessary to shut offthe water at the curb stop box. I understand that the property owner is liable for the water line from the main to the premise. (Per City code 402.06) I also hold the City of Fridley andlor its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to, , sod, yard,landscaping,trees,shrubs,driveways, sidewalks or the curb stop box and service line. I understand I am also required to obtain a penmit prior to any work. . �"` Name: Address: Phone Number: Date: �� Signature: Wifiness Signature: FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND 5ANITARY SEWER ADA�IIMSTRATION (Ref Ord No 113,464,565,566,629,638,662,422,988, 1144�1156,1191) 402.05. PERMTl'FEE Prior to constructing or repaix of any water ar sewer line connecting the existing municipal system and any house or building for which the application is made,the bwner or cAntractor sha11 be required t4 obtam a permit for such connection,and shall pay a permit fee as provided in Chapter 11 of this Code. .After such connection has been made,the VJater and S�wer Depaz�ient shall be notified. It shall be unlawfiil to cover any conneeting line until an inspection has been made and such connection and the work incident thereto has been agproved by the City as a proper and suitable connection 402.06. REPAIRS AND MAIIVTENANCE TO CONNECTION After the initial�onnection has been made to the water service curb stop bux or the sewer lead at the propezly line or a water service or sewer lead has been extended to the property line for coimection,the applicant,owner,or the occupant or user of such premises shall be liable for all repairs requu�ed to any wa.ter line and any sewer lines necessary fnr connection of the premises from the main tn ttie premises. Tf the properiy owner requests maintenance services or repairs be performed by the City,the properiy owner shall be charged for the costs of the mauatenance and/or repairs,including any necessary street repairs,at a rate set ann.ually by an administrative policy. Tt shall be the responslbility of the applicant,owner,occupant or user to'perform standard maintenance of the sewer service line from the premises to the main includittg debris clearing or root cui�iug and to maintain the water service curb stop box for operability and at such hei�t as will ensme�at it remains above the finished grade oft�e land or prope.rly: (Ref 638,1156, 1191j