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Meter Swap I � �Q"'�� n`�`t�°s �:€j � ;±" �,. �a � '� p�! �1 ,. k '�!�'a.� n.:� �� r ,k� � � � ��t�r no�iarta� t , Address J �� G'✓' !�'�G+�L,c��,� ,�r�'. Name ��'t �r�f�' L�c�t�,M�r�`..�'�.� _. __ : Date �"� �""� � Old Meter Number � .. /.� '�� _ Old Meter Readin �� 3 � �� Replacement No. �.� �t�.� �� Replacement Reading � Replacement Make ✓��r+,.�- Remarks: � r d.�. � .c-�'i-�.- `'� ;,' S igned � -�''� ,`�:_ � � . , � � = ��-� ��i��S� �1�-S�3J INSTALLA�ION ' G.n� AUTOMATIC METER READER F►�n��r Address ��\ ��J2� L�- �, � Name 2�L �t��I��,t�"�---t� Date t � -��—�,� Old Meter Number �y� Old Meter Reading Replacement No. Replacement Reading � Replacement Make J�7- ERT# ��J� ��I�i Replacement ERT# Remarks �� Signed: F��st ft�r�er� R�r# �i�y af Fr�dl�y �ef �: �1-12-�r4 _ 1�1l�112 Fi�Tj�e= T�waEer ai�/Ran E�►: YY� �ent: Wat�s Ci`��: �c En�er� AYdd�ss: �531 LAKE I�iAC . �12-741-8460 tl�te: 1Q�3�112 8�+C011�1 t�x�er: �[�: �#2(1�2-016D7 �equw�[]�a�: T�w�a aB far�e i�' E . .......................� � .......e.� .m..�_____�e.........,..........._a.e..,_......._ �........ _........,�_.................._,�.. �. �.-. ��,.._.._.,. _ '... �� '� �� _��'yY�t . 4�t��E1 �. _ � �_.��__�_. --- .__ _._. . � �� _._ ...__..._._ _..._...._�.�............�______._.___._. �:. ��_�� ._..._,�___�...........______r._.____ , ' �� f+nr �rv� i� . �i�y t�f Fridl�;y ��r�� -�2�a ��: �o�r�r2�o�2 T,�� r�..�-�� :: v� ►�. �v$ 3 t I�,r�s� /'�,.� l� �� Add�� 'd�.l� . �12-�41-�+46Q "'�36 s�a�a ax�: � �� „ �c� ��: ��z-a��xn ��: T�.�-��,r �� ,� � � ,,F a. �! � �r b SJ'� � Sh � � �� .e�� e ' aw,,,�� 'rL l�r°� u� � K Y w��} I� �,a� � �c � a� � � �{ t�. �aj. Y � �� , � � ________�______w.______��_______�_____ � .____ _ ___�__..� _ � � � [o �t� l�_._� . City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe � hereby authorize the City of Fridley and/or its employees to do what is necessary to shut off the water at the curb stop box. I understaxid 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 andior its employees harmless for any damages that ma.y occur while doing this operation. This to include, but not 13mited to, sod, yard,landscaping,trees, shrubs, driveways, sidewal�cs or the curb stop box and service line. I unders�tand I am also required to obtain a permit prior to any work. Name: Address: Phone Number: Date: Signature: . Witness Signa � FRIDLEY CITY CODE C�IAPTER 402.WATER,STORM WATER AND SArTITARY SEWER . ADMINISTRA,TION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191) 402.05. PEItMIT FEE ` Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shall be r$quired to obtam a permit for such connection,and shall pay a permit fee as provided in Chapter 11 ofthis Code. After such connection has been made,the Water an.d Sewer Department shall be notified. It st�all be unlawful to c�ver any connecting line until an inspection has been made and such connection and the work incideut thereto has been agproved by the City as a proper and suitable connection. 402.06. REPAIRS AND MAIlVTENANCE TO CONNECTION Aftar the initial connection has been made to the water service curb stop box or the sewer lead 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 repaits required to any water line and any sewer lines nacessary for connection of the premises from the main to the prernises. If the property owner requests maintenance services or repairs be performed by the City,the property owner shall 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 responsibility of the applicant,owner,occupant or user to`perform standazd maintenance of the sewer service line fram the premises to the maiu including debris clearing or root cutting and to ma.intain the water service curb stop box for operability and at such height as will ensare'that it remains above�e finished grade of the land or property: (Ref 638, 1156, 1191j � R�qUe�t f�r �rv�e R+�p�rt - Gity of Fridley Ft�ferenc�'Na: G�1-11-41� [}ak�: 1�t21.�'2'ti11 F�equest T�►pe� ktstaN AMR tset�er Ent�eci By: W�dy F��# �artr�ent: Wat� . f:#ix�t�ame: �+lalt _ 5�83� MU(�RE LAKE QF�1H �ek Phc�: 612-741'-&t�D Sc�duied Date: 1�J27f�i1 8�3Q AM Prap�erty�rre,r: Locatic►n[7et�s: �ieat Details: kistaN AMR �� At�ic�T�c�en: ' �� r-7 S' '� �� j � � I 3 , j c�x�J��-� — .��5�i� � c�c;��.x� — C�a�1 �?� 50 � ; � �� .n��-r� �� —�.� i � ti�� - � � � �-� � - �� a� l� �� ____ __� __. � __ _�_ � ._ _____� _ _ _ __ _ . ��,�P�,: . , ��: - ��: ��t�� ' - C�`�—�� - - . � � City of Fridley Water Department 6431 University Avenue NE Fridley, MN 55432 (763)572-3566 ��We hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb stop box and service line. I understand 1 am also required to obtain a permit prior to any work,if necessa ry. Final meter readin (old meter) � � /��.� � � B Name: Address: ��\ "x`�Q� �C�.—�"-�„�--- Phone Number: Date: l�� Signature: Witness Signature: FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464, 565,566, 629, 638,662,922,988, 1144, 1156, 1191) 402.05. PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shall be required to obtain 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 Water and Sewer Department shall be notified. It shall 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. 402.06. REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead 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 repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the City,the property owner shall 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 responsibility of the applicant,owner,occupant or user to perform standard maintenance of ° the sewer service line from the premises to the main including 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 of the land or property. (Ref 638,1156,1191)