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Meter Swap �� _ G� �`��'ks�-�r�;�f'�)�, � ��� INSTALLATION G.n,o�. AUTOMATIC METER READER FRIDLEY Address f�.71� � ��;'��C ��� Name �C�.l,�_��iZG"T'r'�=- Date �`�d R-�� � Old Meter Number G c � Old Meter Reading � o� Replacement No. � �__ Replacement Reading � Replacement Make � ERT# ���� iJ�C7�G7 � Replacement ERT# Remarks: ��2-� Signed: F��q��t fc�r�rv� R+�p�►rf , �iiy c�f Fnd�:y � r��: ��-�2- �: ��r��2 7�� ��� ���. � : . vu� . Aid�: �'11 A�BlE ST NE � ��-�'A9-1�7 . i3i#+e: 7l7�7�7�AM . t�a�t�: � � []eta�= /1i�i T ' _ ��d �ie�er #� �q,t.-���`��' �+�l�d r�:ading: �, '?� , ID ��Dr� � ��l�r ��:�r# e�� # f��v� �t�ading: � �E�T�' �������p � I � � i � _ __�__ _. __. _���___�_ _� _�___ � ..� _.�_ _._.�_..._._.�. _.. _____�_____.__________ � � ���� E � . � �: � —'—� ,� � �-_�a � _1� _ . _.� / °+ City of Fridiey ' Water Department 6431 University Avenue NE Fridley,MIV 55432 (763)572-3566 ���,� hereby authorize the City of Fridley and/or its employees to do what is necessary to repface the water meter. 1 understand that the property owner is liabfe far the water fine from tfie main to the premise and ail interior plumbing. �Per City code 402.06) i aiso hold the City of Fridtey and/its employees harmless for any damages that ma�occur while doing this operation. This to inc{ude,but nat{imited to;valves,piping,walls,floors or the curb � stop box and service tine. I understand f arn also required to obtain a permit priar ta any work,if necessary. Finat meter reading(old meter} l , � ��� Name: Address� � � � Phane Number: � Date: � � �� � Signature: . Witness Signature: FRIDLEY CfTY CODE CHAPTER 402.WATER,STQRM WATER,AND 5AN{TARY SEIMER ADMINiSTRATICIN (Ref Ord Na 113,464,565,566,629,638,662,922,988,17.44,1156r 119].) 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer fine connecting the existing municipal system and any house ` or building for which the appVication is made,the owner or contractor shall be required to obtain a permit for such : connection,and shail pay a permit fee as provided'+n Chapter 11 of this Code. After such connection has been made,the Water and Sewer Qepartment shall 6e notified. It shail be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 4DZ.06. REPAIRS AND MAINTENA.NCE TO CONNEG710N After the initial connection has been made to the water service curb stop box or the sewer iead at the property line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner, or the occupant or user of such premises shall be liable for all�epairs required to any water{ine and sewer lines necessary for connection of the premises from the main to the premises. tf the property owner requests maintenance service or repairs be performed by the City,the property awner shatl 6e charged for the costs of the maintenance a�dJar repairs, incfuding any necessary street repaiss,at a rate set annuatly by an administrative po(icy. It shalf be the responsibility of the app{icant,owner,occupant or use�to perform standard maintenance of the sewer service line from the premises ta the main including debris clearing or root cutting and to maintain the water service curb stop box for opec'ability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)