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Meter Swap �� � x �� �� ;� �rs- � ,:� �,���� �' .�-f �:� ���� ``4 �J 1 City of Fridley Water De�artment Address ILAJ�� V���� Name ! ue��S� Date ' �`�tT� Old Meter Number� � Old Meter Reading � � Replacement No. �-.� Q Replacement Reading � � Replacement Make �� Remarks• ()�� �VJ�i�y ; ;� �� Signed . . � .� z�,�;� �i��rs-y������ ��� �" INSTALLATtON GTYOF AUTOMATIC METER READER FRIDLEY Address � Name ��' � �C L S - Date 1���- f � �� Old Meter Number � � �� Oid Meter Reading �, � Replacement Na Replacement Reading f� Replacement Make �c-�_F ERT# E��� c���Ze� � Replacement ERT# Remarks ����, Signed: ���t f�r'�� R� - � �ity of �ridt� F� �: 6{91-t2-4�74 �c: �''31f2il12 �Tjl�e� �R�eter ���r� '�� t��: w� t��: �� i��C1�AL5K� _ 6311 �T 1� � 763�7'4-p110 ��e= �11J.ZLi7��1PM �_ �� t3�ner: P �TYI � ��: � m ��: � �� � . �i� �t��r� .����`��`��, ,�i� ��«�: a��� �c.� � ��► ���� # �er�r ���ding: � �R`�'�' ��������. ; � � � �___ _ _.______. __ ___ __.__.....__ . _...._..�____ ___ _ _ _ __________. � � � �_ ._ ._... _ __�.��. .._._____.....__._ _ � �___ ____.____._.__� ___ _ ____ ______._._.__. �._ ------- _ � �.��`' �� w _..� �__ � � , � ' - City of Fridiey Water Department 6431 University Avenue NE Fridley,MN 55432 (7G3)572-3566 I/we hereby authorixe the City of Fridiey and/or its empluyees to do what is necessary to replace the water meter. f understand thaC the property owner is tiable for the water line from the main to the premise and ali interior plumbing. (Per City code 40Z.06) i also hatd the City of Fridley andJits emptoyees harmless for any damages that may occur white doing this aperation. This to include,but nat limited to;vaives,piping,walls,fioors or the curb � stap box and service line. 1 understand I am alsa required ta vbtain a permit prior to any work,if necessary. Final meter reading f old meter) �\ , Name: Addsess: ���� ����� Phone Numher: Date: �'��� • Signature: �t "_`�'�'�-�"�'�-�`'� . Witness 5ignature: , FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WAl'ER,AND SANiTARY SEWER � ADMINISTRATION (Ref Ord Na 113,464,565,565,629,638,662,922,988,1144,1156,1191) 402.05.PERMtT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house or buifding for which the application is made,the awner or contractor shall6e required to ohtain a permit far such connection,and shall pay a permit fee as provided in Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shalt be unlawful to cover any connecting line until an inspectian has been made and such connection and the work incident thereto has been approved by the Gty as a proper and suitable connection. 402.06. REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has 6een made to the water service curb stop box or the sewer lead at the property fine or a water servi�e or sewer lead has been extended to the property Ilne for connection,the applica�t,nwner, or the occupant or user ofsuch premises shall be liable for all�epairs required to any water line and sewer tines necessary far connection of the premises from the main ta the premises. If the property owner requests maintenan�e service or repairs be performed by the Ci�Cy,the property owner shali be charged for the costs of the maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative policy. it shall be the respor+sibility of the applicant,owner,occupant or user to perform standard rr�aintenance of the sewer service iine from the premises to the main incfuding debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade af the land or property. (Ref 638,11�6,1191)