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Meter Swap '� ��..-r��---- J (��37s-�� a� � INSTALLATION ��.n,� AUTOMATIC METER READER FR(DLEY Address �,�1�) ' ��'"� '�'T� Name �.C�(� �-.��2_ Date ld`-�l� Uid Meter Number Old Meter Reading '7 Replacement No. Repiacement Reading � Replacement Make �� ERT# ��, ` V �V� Replacement ERT# Remarks: �o�`� Signed: . " Request for Senri� Rep�rt City af Fndley ��ra�: s�1-�i-�a,z ��: ia.r25�a�i � �,r�� r�r�� Frn�ey: w��att I�epartment: �1V�er Gti�en�t�ne: Cc�ra Lukz Ad�ess: 6+D0�5TH�T NE C�ac:k Rhone: 651-�46-�7� �c�edul�d Date� 1�i3112011 i�00 RM �p ' Praperty C)wner: t.c3catiora I7�aUs: Request [letail$: Install AMR 1�dicm T��: 1 r��- F� � � � � � � � ; ; � � �� o�� -�� -- ��7�6�3g �� o�.� '�.�� -- �"16ro � �� ,�� rn��- ��s�a5'3 N�-� '��-�'u�— � �� z.� � - 333��65 �� Re�pans�e Persarr: �v�: __ t;orr�fe#i�Ila#e: —_.__ ___--�____�__._� �Q�izen Nc�i�ed Cp-3� -� � � - _.. � _.. City of�rid.I�sr �i r'atz3 De�artr�?e�t 5�31 L?�ve�sit�T_A v enue i�aL. Frialey��'�T 5��2 (ib�) �72-3�b1 � Uwe � �'n, W�� he.�eby a�i�n�c� � �' - th„ �lr� or r��.ley a�d/or�rs employe�s�fl u.o ��af��ec�ssa�-V t�=;,�lacQ�.he raat�.r meter_ 1_unde�s�tand thai i.�e propz�-iy o�er is 1_iable ioz ihe�aater line�o�ihe main to t�e pre�s� and all i�.i�rior �lu�bing. (�er Ci� cade 4C�2.0� I a?sfl �old i3�e Cit;j of Fridley anv`os iis e�lo,�e�s haml�ss fcr�n.y damaQes t�ai�a�o�cu�white �oin�t.�i�is operaTifln. Tl�is to incl-a��;bui nai 1i�nite�.to; tialves,PiP�nff �a31s, fioors or tue c�'� sto;a bo� an� se��i�e 1i�e_ 1 Lnders��d I am �isa requ�red i.0 OOIc.ItZ 3 pti�it p�_o�� an��io-�, iz�ne:;,ssarV- Name:�i�('G Lc �}� _4��ess_ �� 5�1f1 S�' �E 1�hone i�umber: (�j� 2��9 1�`�� DatL: 1 O = 3 � • 1 � Siffnat�re: �`nTi�ess �i�ature_ __ __ _ _ __ _. _ 1i .'-) .�i:T L'i(11 �'1.��9� - �i��.i'��',.i.'�_=��2.�?�3��`�, J��'`�'�`J�?"�7!��''��`�rtl'''� �1�1'��i`�:�1.''��3✓v�� - � :3-��'3��i��.�� . (kei Ord i�T.o 11�,104, JbJ, �o'o, 0?5, 030, 0'02, 92?,930, 11�, l l�a, 1191) �iD2.fl5_ ��I°d�'�'� - P�or to cansi7-ucan�or rep2ir oi any W3Iz:or sewer 1_ine cor�ectiu�the e<5istinb municipal system and any house or buiIdin�_or whic%i i�e aLpl�cation is m�de,the o�ner or contractor shall be re:�u3redZo oo'rain a pe�mit for such conne�tian, a�d sha11 nau a pelsiii fze as provideci i�Cha�rer 11 oi-i�!is Code. _�frer�such cannzctinn has bLen�ad��e Waier��Sz�ve<�epa�—tmen�a�all be no�e� it sha]1 oe ur1a�iL coz�er any conne��iine untl aa iuspecrion has oeen�ade and su�h conne��on and the worlc in�ideni i��reta has been ar�proued by�e Ciiy as a�raoer�d a�i�ble canne;tion_ �ai.o�. ��.=�t��r a��r�:�� 1�� er the i�i�al.conae�tion�as besn�ade t��i t.�3rer servic�c�a;b siop bon or��e�ewer iead�i`�e proper�Z line or a�ate�ser�rce or seu7er'•ead�as besn z;��nderi�o ihe prapex--ty iin�f�r can,:�ectio�;�e applican�, owner, or the occupant or�ser 3r suc��rzmises shall'oe liable tar ai i re�,�airs i equirzd to au;� water liue �nd any se�ves lines netiessa.�,�Tor conueciZon�s�e premises 1-0��e m-ain tn �.he prem�es. If - the nrop�-ty ��er T�uesis��niznance se�v-�ces or re�airs de perzorme�by The �iiy,�e proper�� ow�er shall be c�argeci ior�e costs of tihti mainte�anca a�ci/or��a�rs, �ncludin�any necess��sireet repairs,at a Taie set�ualiy by an a�mi�isxaii�a policy. I_sha31�e the rzspcnsibiit�r of the a�plic�r, o��er, o�;�s��T or us�r to pezi.�zzn st��dard m�.nzeuauc�oz ihe sztivez service�e aom the p?-enises io the�aan�nclu�g de'�.rs c1Q��ns orraoi cni��d.io maiaia�n ih�waiar serTrica curh st�p b��i�r o�erabi7ii,r��at suca hei�i us�i7I ensnse��at;�rem�s �ba�e'�ue�.s��:i�ade oi we land or�ro�cPnv_ �K:,i 634, 1��, 11�1 j