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Meter Swap '� ��- 1��9�s-��z� � � INSTALLATIUN c�.�� AUTOMATIC METER READER FRtDLEY � �1 Address *�/�U��"` �''" �� Name � 1�M ��--3t� Date � � �"'l� Oid Meter Number � �� Old Meter Reading dCS� �� Repiacement No. "1��`[ ��j� Replacement Reading � Replacement Make ��. : ERT# �?J�?JIF��J�, V Replacement ERT# Remarks: (.�a-- Signed: �. ReqUest f+or S�ervice R�part • City flf F�idley R�erence Nc�: �1-11-3�Q �'k��: 1 tl11�D11 Raq��est T�pe= instafl AMR n�et�er b��ed By�: IMe�ciy��t t��tm�t: 4ti(a��.r CC�iiz��a�ne: Luc+�e l�is fid�ess� 581�6TH ST NE Ca�aek P�e: 763-�a71-2171 xhedui�d D�ate: 11.�3/'�i 1 9�I1Q AM �61�r Sc�, Prc�p�#y(h�e�: Lc�ca�ion[�a�s: � �� O�etails= irestall Anr Ac�ic�n T�n: �� : �y °►��': lt��5.;1� �� : y�3� �� . � 3�� ' ; ��%�c,�s� A� � E f � � � � � � � � ' � i j i i � � ; � , R�e Pea^san: ; �+�'� ' , __ _ _ __ __ _ f�arr��+on I�ak+�: �t�izen Nc�ed i � � ` � _ �' ' 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 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 Fritiley andlor its em�loyees harmless for any damages that may occur while doing this operation. This to include,but , not limited to; valves,piping, wa11s, floors or the curb stop box and service line. I understand I am also required to obtain a permit prior to any work, if necessary. Name: r��z i�'l..ct-.� �h� ��.5�-c,t�%2 Address: �� `�" S � � �,' .K Phone Number:7(0�--�7�� 2�7/ Date://- ��'�/ Signature: � 1 � -�ti Witness Signature: �. �� '�a� FRIDLEY CITY CODE CHAPTER 402,WATER,STORM WATER AND SAIVITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191) 402.05. PERMTT FEE � Prior to constructing or repair of any water or sewer line connecting the existing municipal system and 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 cannection has been made,the Water and Sewer Department shall be norified. It shall be unlawful to cover any connecting}ine 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. REPAIltS 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 e�ended 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 connection of the premises from the main to the premises. If the property owner requests maintenance services or repairs be performed by the City,the property owner shall be chazged for the costs of the maintenance and/or repairs,including any necessary str'eet 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 ensvre that it remains above the finished grade of the land or property. (Ref 638, 1156, 1191)