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Meter Swap '� � ,�..1 t-135�"-�-j�-1 S 3� � ��-`� INSTALLATION unroF AUTOMATIC METER READER FRfDLEY Address � � � �7�� W G Name_ _ ! -41"- l -� -.�Cs r� Date �� ` � �� Old Meter Number � � 7`I� � Old Meter Reading 't 3C� �'� Replacement No: ��3J�9� � � i Repfacement Reading � Replacement Make 1� °�_°FQ� ERT# 3 �3 d 3 �sa '/. Replacement ERT# Remarks: �� Signed: �C�� f+�r;�erv� f��p� . - �Ciiy a�f �ri�l� � �� t-�t-��s� ��: ��rzs�o�� T�� : t�t� ��t: w� �r�� wu� �� s�wv�r� � . ��-c�a s�a t�= ��r�rr �^VeS �� : �� _ l �15��-�-��2 pc��1��2�_ �Ttd �`�$ � o�c� ��►�- ��0��70 JU��w.m�—��2.� — �1�5��L�� Nt� ��`� �� T.�-- 3 s3�33�� _ � �_�____ ...__ ��.��.._.�___��_...__� _-�------------ _ _.� �: 3 � �__ _�__��__. _._ _______.__________�__�._._ � ��= ---.--� ��;�,� �� _�' � � . ;.�� . . - City of Fridley Water Department 6431 University Avenue NE Fridiey,MN 55432 (763)57Z-3566 ��We hereby authorize the�ty of Fridiey and/o�its employees to do what is necessary to replace the water meter. i understand that the property owner is liabie for the water line ftom the main to the premise and all interior plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harr►�less for any damages that may occur while doing this operation. This to include,but not limited to;valves,piping,walis,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. Finaf ineter reading(old meter) 0�� Name• Address• ��' �/ `��s-_-- Phone Number: Date: �� 1�_ _— ,` � �� /V ' Signature• Witness Signature: FRIDLEY CITY CODE CHAPTER 40Z.WATER,STORM WATER,AND SANfTARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191) 402.05.PERMIT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or buildin�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 Chapte�11 of this Code. After such connection 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 the�eto has been approved by the City as a proper and suitable connection. 402.06. REPAIRS 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 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 sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be pert'ormed by the City,the property owner shatl be charged for the costs of the maintenance and/or repairs, including any necessary street repairs,at a rate set annualiy by an administrative policy. It shall be the responsibility of the appiicant,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 ope�ability and at such height as will ensure that it remains above the finisheti grade of the land or property. (Ref 638,1156,1191) , � Req��est for S►erviae Report City of Fndley i�erence Ncr: fiifl-ll-�al �a�e: 11/3{l!2'411 F�ue� T�rpbe� k�stall 1#NR n�e.#+e� Er�t�ed Bjr: Wexuiy#-��t f�p�tmev�rt: Wtif�� Ckiien N�ne: Mr�s�a A�dr�s_ �35 57TH AVE NE C�a�P�rcx�e: 763-5T1-01� �d�eduled Date: l�ltl�11 2�4 PM � Pr�pe.�y C�vner: Loe�ion[7eta�s: Reque�i DetaAs_ k�stap�1b/R A�tic�T�c�: �I a, $ � t � � i ��a �,,,.�+�r�- � � � � o -� q � : o ��- re�j� �� 7 Q ° ' �e w ��' � LI 3 �� `�'�q ' r e �,,, �-�,�d,y►� f� � �-T �- 3 "� 30 3 �1s�� _ _ _ __ �,�P�,: �;%i��_ _ ��: �,��: ��ra�d � � - � �,� . " City of Fridley Water Department 6431 University Avenue NE Fridley, MN 55432 (763)572-3566 ��We 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 Fridiey and/its employees harmless 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 1 am also required to obtain a permit prior to any work,if necessary. Final meter reading(old meter) � �f� I �� Name• Address: Phone Number: Date: Signature: �� R Witness Signature: v � FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464, 565, 566,629, 638,662,922,988, 1144, 1156, 1191) 402.05. PERMIT 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 connection 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 and suitable connection. 402.06. REPAIRS 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 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 sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the City,the property 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 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 ensure that it remains above the finished grade of the land or property. (Ref 638,1156, 1191)