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Meter Swap 1�D(O�r?S-�f�ol'3fi� �� ���� INSTALLATION crnroF AUTOMATIC METER READER F�a� Address � � � ` �� 5� iV Name �j, ��'CN�� ��'K�5'� Date 1 �" � —�� Old Meter Number ����3 Old Meter Reading � � Replacement No. �-I °ZS i� Replacement Reading � Replacement Make � ^� ERT# � Replacement ERT# Remarks ��� Signed: Request far �enr�ce �2ep�rt ? Gity of Fnd�y R�er�,ce'No: �1-11-:3� D�e: 1�12�,���11 Requeat ��rpe� hstaU AMR n�et�r F�tsred By: Wendy fiiati [�p�tment: W�er C�izen N�ne: I�atha�flihrestaci Ac�ess_ 5877�TH ST NE Ca�ack�one: ?G3-572-1�88 ��I�d Date_ i 1i412011 2�30 P Pr�sperty Or�m�x: Locatic�n C3+�a�s: R� Deta�s= k�stall AJr�IR Acticm Tak�n: fi��s�-- ��� � � � � € t � E ��Er.��- �-- �5b� � 3q� c�`P.���— O� ��� ���3� � N��w mr-7�z� - 4'3s`�a St� � J�.� ��l� - f� �� � — �3�a��� �ns�ke F�n: �P��' Gorr�l�Uats: � � ��iz�Idat#"+ed � �� - w - i � t�1tTj Ot�II�z�I �'aier De�artt�e�t 5431 L?�versity_�v enue i*a�1..'. , F�idleq��'�T 5��32 (%b3) 572-3��i1 � Uwe , �� �''f'�.,- _.. he�ebti a�o���, the ; .- C�r� oI F��ley a�.d/or irs - eznployetis ifl �o u�hat�;�e��ssaxv to_:.�la�e�he c�aie�-meter_ �_unde�stand thai i.�e propzi-iy o�ner i� 1_ia.�le ioz i,he�aater li_ue�o�.ihe maiu to t�.e pre�s� and all i�i�r�or �lu�bi�a- ('�er�i%v code 40.%.0� I a?so '�old�e Cit;r cf Fridley anv`or its e�l�;�e�s ha�nl�ss ier any damaQes t�a�may oc�u�while :�oinC t.�is operaTion_ T1iis io iucl-a��;bui nai]i�iterl to; `ialves,Pi��ng, yvails, f oors or tue c�'� sto��oo� an�se��ice 1iae. 1 �dersi�c� I am. aiso z�quire�.to D'ot�;�. a�ti-�i.i�r-o��o �ny�o-�, iz ne�,�ssa.�y. ��ame: �1� i_�� �t� ��j�- Q���O _�d�.ess: �� / 7 ��� ��� 1'� � 7�'s - ,� � Z-� /7�� � /� �none i�umber: Date: �1 ��1�Ila�jl'�: � - �AJ1�L�SS �l�a-h7T:,_ •-_ :Li �'� .��y Y.ii�l '�1.,��i'� . - ^'-���.�'�'���t��.?�l�.3'�'��,���;'����t��`�`�r�t''� �t�1�.3��'����� :�l�i�]�5'T'���'���� (R�i Ord Na 11�,10�, So�, �ao, 62�, 030, 0'02, 92?,938, 11s=4, 11�6, 1191) �a2.fl5. �����'�'� � P�or to cons�a-uc�n�or rep�.ir or any�N3tZ:or sewer line c�r�eciin�the e;isting mw�icipal system and any hous�or�uildi.ag=or�Ahicn i�e alipl�cation is m�de,the o�er or contractor shaL'.be require�.to oorain a pemii far such conne�tion, a�d s�zll;oa�a per�nii fee as provideti i�CIlani�r i l oi u'�is Code. �frer�such cannzc�an has bven�ade,the W;aier�n�Sztive<�ep�-tmeni��]1 be no�e� it shall be urlawn�.i�L caz�er any ccnuec�n�iine untrl aa inspec�ion has be�n�a�e ;�nd su�h co�neti�on and ti�e worit i��id�ni t�ereio has been appreued�y�e Ci�T as �prooei-��c},��ble canne�ti on_ �02.�o. �a�3,�_�['�1°ry�..-'�_i1°d'�'��T d_i'T�:i��''�i ���1 d��'�'��1�T Afie�t:he iniiial.conaeciion ias bee��ade t��e�.vat�r sen!ice c�.�;� stop bo�or��e sawer iead at`�•e �rop rty]ine ar a wate�ser�rica 3r seu�er'ead�as be�n e;iendea�fl�e pr��-iy iine f�r con-u.ec�ion;�e �pplican�, owner, or the cc�u;nani or�ser 3r sach�re7]"I1Ses s�all'oe liable tor aii re��rs rzquirzd to anv ;vater line�nd any sewer liaes ne�essa,,�Tor co�necizan�s��premises�on�e mauL Tn the prem�ses. Lf - the property�,Sr�er,-e�uesrs��nienance serv�c�s or r��ai�s�e�errorme�by rhe �iiy,�e proper�;�ow�er shall be c�arged ior�e costs o2 ih�mainte�anca a�d/o�r��a�rs, inc��:din�anV ne�ess�rJ si�-e�t repairs,az a Taie set�aaliyo uv an admir�is�aii��aolicy. I_s�a.11�e the r�s�cnsibi?it�T ufthe a�p�c�i, otivnez, oc�u��T or us�r to pezi�rm s��dard m��nieuanc�oI ihe setiver servicy 1�e ffam t�U p�n.ls�s io tiie�ain�.tclnriiag de'�ris c1Q�-ing or rooz cn�¢�cL to mainra�n ih�waLr serTrica curb st�p bo�lOP 017�I3177�1"C'W oIl�flt S11Ci1 h�iQi`tt us�ill ens�se;�at;t�nzaius abn�a the f�is�e:i�adU o�u�e laud or�roppriv. �K�i 63�, t���, 11�"!j