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Meter Swap '= �� J�s�i�S-�sg��J INSTALLATION G.n�. AUTOMATIC METER READER FRIDI.EY µ Address �� '""� `— �� Name ��rT� ,/U��Z.�i� � Date �l� �TCJ'�'�, Old Meter Number a �o�y� OId Meter Reading 1 � Replacement No. 3�0�'31� Replacement Reading � Replacement Make � �-�. ' ERT# ��J� Replacement ERT# Remarks: �� Signed: R�q�e�t #or Senr�ce Repa�r# � t;ity �f Frir�l�� ,.��,�: (�p�_ ��. S�fiS�I o�r�: 1 �..��c�_1� fleqaext Type-�V/v� �� c�en Entered E;�� Department: L"iEken Nama �,QS`� ��'V Addrtss. � � 1 V " ��' CaflbackPfrotse: ��F.1�— JUa," �� Sched�et!Date: Properly tivw�r: Location Detmis: Req�eat i?eimis: �� 51�u?o�'+`- � Action T alcen: ��C a�� 3C�� ►� � ��►rv�,c��-S � �' Ar� 1��'� csQ lC-'�[ ��,�n� + Flcsponsibie Pesson� �lppro�er: __. __... _...----�---- -� _. __. ..__.._----...___ C�izanNati�iad �.�►�n D��: , �(� o`?J`�-�l� ____ ____..r_---�-- _____---- . F�eq�t f�r Serviae R�pc�rt ' Ci#y of Fr�dl�y ��r�: s�t-Y�-� Q��: ».r2�zo�t Req��esE T�e� �rstaN ANIR�t� Erikerec!By. W�r►�dy��i [�artmer�t: Wat� t`atiz�Naar�ee: M�t IVa� A�d�u� �9i8 4TH ST NE C�aek�a�e: #I1��37-0618 Sc�edul� Lt�e_ 11,�L81Z411 1�Q PM n��, PmpeM#y C:3w�ex: v� �� 1��e#c�s: Request O�etails= krstall/4tr1R Ac�i�T�+�: � j��L - � � i � � � � � � � r��-�� — �� I'�� ` c�- c�� ;�C,-- p� �� o � � ,v� �� — �,�� t ,�,' ��'� �-- � � � � � ; �-� ---��1� S�`�(� ` � � . _ _ __ _ _ _-_ � �s+'6�P�: ��: " �e: 'zen�d II -��-< < City of Fridley Water Department 6431 University Avenue NE Fridley MN 55432 (763) 572-3561 Uwe hereby authorize the Ciiy 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/or its employees harrnless 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 I am also required to obta.in a permit prior to any work, if necessary. �-�--l�-�� ^�` . q `7�i r Name: (� ( IU Address: � l / (7 �taS � �V � Phone Number: 7� � " J��-`' ! C`)�Date: ^ � Signature: Witness Signature: FRIDLEY CTTY CODE CFIAPTER 402.WATER,STORM WATER AND SA1vITARY SEWER ADMIlVLSTRATION (Ref Ord No 113,464,565, 566,629,638,662,922,988, 1144, 1156, 1191} 402.05. PERMIT�EE Prior to constructing or repair of any water or sewer line connecting the e�cisting 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 cnnnection 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 aud suitable connection. 402.06. REPAIRS AND MAINTENANCE TO CONNECTION A$er 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 any sewer lines necessary for connecrion of the premises from the main to the premises. If the properiy owner requests maintenance services or repairs be performed by the City,the properiy 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 admi.nistrative 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 ofthe land or property. (Ref 638, 1156, 1191)