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Meter Swap '� �?��-�� ' INSTALLATION cinroF AUTOMATIC METER READER FCZIDLEY Address `;,�{� �l�GtT j�, �� Name �.��i� i��l� �f"� Date C{'c�� 1 Old Meter Number � V Old Meter Reading � � Replacement No._r,�`� � � � Replacement Reading � Replacement Make �C. ERT# � Replacement ERT# Remarks a � �� 3r� Signed: � -.-��•�'f,�='� l� J� -l � �� :��a�� ? :�nnxd� : � �� — :�ost�ad a�uc�dsa}� i ; i I I � T� �e,� � ,�a� a`�� 'la/�' d� �a� � � _' ✓r.�.�-,� ��1,� ��.'"t'1 �+�� D n -f.� � � C1°�S � ,�� ..� �� o -,-�.-�--�^'� -� -U� l _ __._._. _._._��1�d ....Tl�,,.� �O'ra�unl :s�e#�(I � #�d ��C1 uo!;e�a�t Z�PS� ' ��'"t3��d 11d 0£�k t EO�f€J'l l �a�'(l P�'!� 8�E�Z�£9,L ��'� 3M 1S M31AN1f3l�9�'5 =� 6u!4�kf��Sr��-es� :au�e�uaz� ��M ��C] ��i�M ��8 P�'�3 '�l�P��►'�i =�1� ll{DZJ£��.1 ��#e0' �ZC£-li-L� :�sp��aua:ra}� �� }l��j �11J� .l�?� }'S3(1�� f��ques� for Ser� Reporf City af Frid�:j/ Fief��r: s01-11-3�4�4 D�e: '� 11 R� T�pe� Ir�stall AMR�tex 'F1rt�d By: �fdendy�att C�.p : Y�a��r C�aF�rr �Jar�e: � � Ad�: 5Q�CLEARVIEW ST WE ' Cal�adc�'hvne: 763-572-�227 �c�dul�d [3�at�: �J'Z�11 1{�_00!tiM �u r,�c� Pr�periy��7wr�er: Lc�e�tic�n Cxekails: � Detaila. C:trar�dd�eter Acti�T�en: �.��f�t�� ,�.1P'� �,� � � � � � � � � � � �,� r^�� 3��-'7 E�� c� 3 v � � ��"�; ��`; � � �,� `tG �� w �,��:� 43039442 � -�:� , a � � 6 � 7a � � � �._ �, _ �� . Re��s�Pe�r,: ��rer: ' _ _ Cc�rr�l�on t}ate: � ��zen�ed / � � � —� — �� !�;:- , . r l�l� Of�Il�2;T �'.ate�De-�a�ent 5�31 L?�versitST_�v enue��L , �ri�.��r ��? �%b�� J��->j�7� � Uwe he�ebv aut�o��e �.h� �i�r oz rii�ley a�dlor its _ em�loyetis�fl �o �haf y�e��ssazv to r�-�la�Q r.he�at�.r meier_ _T_unde�stand t11ai.;.�e proper'ty o�er is 1-able ior ihe�rrater line r''�.-o�ihe main to t�e pre�sV an�all ini�r�or �lu�bi�a- (�ei Ci� cod�4C�%.0� I a?s� '�o]_d i�.e C�ty cf Fridley ancv`os its e�nlo,�e�s �ar�less icr any dama.Qes t�a��a;�oL�u,:while �oin�t,�is ope�aiifln. This �o in�1a��_bui nai li?nite�i to; �ialves,pi��n� sva.ils, f o��s or ti�e c�'� sto��oa� an�se��ice 1tae. 1 , m�.deisc�d I am alsa requ;re��o noTa.;n �.i ti�t p�_o�ie �ny�o-�, i��ne�;,ssary. ` ' , Nam.e: c�G',�,,:frf.�z:.-�-�y � ,Gt.,cr�.,i.Y_ A��.ess_ �C,��1,, ��;��.e�itG- �r7`�?'�' � . — 1�he�ne i��ber: 7G..� .-��' .��t��.� Date: "i �� `�-« r � � S��n ai�,tre: ''- _ -�-��" � v _ _ ,:a � �nTi�ess �i�ature_ " �......�... ;,,�....>��,,,o�:._._.�._. . _ __ __ _ . _ _ __ _ _. __ . �43 ':_ � .'-r�t,�L"i 3 1 '�1.,�� ._ - i��:��ja_'i?��3�y��d',��`!��`�'� 'r�l�$t�l��a��1T��i� �� (Rei OrdiiT-o ll�,1�'-t,�bJ, �o'o, 0'2�, 030, 0'02, 92^,°80, lly!, ll�o, 1191) =it32.(35_ ��I'✓�'��; � �ror to consu-uc�n�or rep�ir of any��aie:or sewer 1�e�oPae�iing the e;,isting municipa.l system and any hous�or�uildia�ror whicu�he alipl�cation is made,the o�ner or contractor sh�be re:�uire�.to oo'rain a pemit for such conne�tic� a�d sha11�au a per_nit fee as providea in Cha�ie;11 oi u'�is Code. _hfrer�such cannzc�on has been�ade.,�a r�.azzr sn�' Se�ve<�e�a�-tmen��71 be no�i�e� it shall�e urlawn�i�L co<�er any conne��ng.iine until aa mspeciion has oeen�ade an�su�h conne��on and the work inciden�t��reto has been appreued by�e Ciiy as apraoer�c�saitable cannertion_ =�02.Qa. � ��_��i�v��I��-�Ta�'i�:�,'�'� �.��'�'��iT �e�the iniii�l.conaection�as beti�mad�te��e z,�ra}�r serT!ic� c�..�;b stop bon or�he�ewer iead ai�e proper�r]in�or a�ate�ser�nc�or seuzer aeac��as bevn e;zyndea�fl the pra�e�-ty linz fnr cannec+�o�;�e spplican�, o�.vner, ort3�e occupani or�ser 3i sac�p�-emises shall'ue liable tor�i1.ie}�� 5 ieqtlired.io a�.y water line�ci�y se�+r-�.r]i�es ne��ssa��zor co�nec�on Qs�e nremises son�e mauL Ta=�.he�remises. Lf - the properiv o�r�er r�uesis�uinierance sE;y;c�s or re�,ai7-s be perzorme�.by r}�e �iiy,�e proper�ou�ver shall be c�argeci ior u�e costs oftih.,maiute�auc�a�d/or��a";rs, inc3LdmQ�3Ily ng��553�J$Cl'Z�t IeF3ITS,&I 3 rate se#�ualiy bv an aaminis�aii��aolicy. I�s�a31�e the responsibiit�T of the a�p3ic�i, ativnez-, o�cupsni or us�r u3 pv�i�rm st��dard�u,nieuanc�oI ihe setiver service '�e from the p_rzIIises io the�ain inc;u�g de'�.rs cl��ng or rooz cni�ff�d�o maiata�n i.h�wai�r ser�rie� Glll'h SI�JIJ E)�n i�P Op8i3171)3f';l"aIlj at s�c� h��i us will��e�iat;�_re��s,:bave ihe f�is��:i�ade o�u�e land or�ro�Priv. ��i 53e, 11�o, 11�':j