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Meter Swap '_ (,.,-��\-� `�f�'�Gs=f�l�v � v` INSTALLATION G.R,o� AUTOMATIC METER READER FRIDLEY Address `lc��/1 1 �� Name /I t4�L�1.�l,L ��zl-� Date L ""��' � � Old Meter Number � �5� Old Meter Reading l Replacement No. �� l p�� Replacement Reading � Replacement Make �� ERT# ��1 �..)-1 �� Replacement ERT# Remarks: (�3 Signed: R�eqt�st ft�c �erv�c�: Ft�p�r� , G��yy af Frid�;y � �. ��-��-�� : � �� T�� t�r��t� � �r:: �t t� . � w� � �: �.� sr r� . �-�s-�ra ��_ ��n�� . n ��a� �^_ I '�� _ ,�� : �� r�: [ _��-��- , � , � � � o� m�� - `�C��Q yS ��7 n�9�-��- �;��( `7C� �u�s��e�-�-- '��ly� , u�1�`�� - � � � � — ��WS� � ��_-___ �______�__ _�� _______� _� _____ � � �� ; , i � � � r .�l�;— � �. � _ �__ .__---1 � .__ _ ._ :�F: {, . City of Fridley Water Department 6431 University Avenue NE Fridtey,MN 55432 (763)572-3566 I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. 1 understand that the property owner is{iable for the water line from the main ta the premise and all interior plumbing. (Per City code 402.06) i also hoid the�ty of Fridley andJits employees harmiess 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. 1 understand I am also required to obtain a permit prior to any work,if necessary. �� Final meter readieg(old meter� Name• �'V1U�,Y l l�i � �I�'11 - -Address•, �� \ ��_�L��O� Phone Num er.�Cl(l�^ "l."l�f l� Date: �O`"�a—�'� Signature: � ' Witness Signature: ��Ua1�`l �,,� . �RIDLEY C1711 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 ar 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 shail be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident theceto has been approved by the City as a proper and suitab{e connection. 402.06. REPAIRS AND MAINTENANCE TO CONNECTION After the initiai connectiort has been made to the water service curh stop bax or the sewer tead at the property line or a water service or sewer lead has been extended tothe property line foc'connection,the appticant,owner, or the occupant or user of such premises shall be{iab{e for al{repairs required to any water tine and sewer lines necessary for connection of the p�emises 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 cosis 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 clebris clearing o�root cutting and to maintain the water service curb stop box for operability and at such height as wilt ensure that it remains above the finished grade of the land or property. (Ref 638,1155,1191) ��s� fc�r ',��t� R�r� +�G�ty af Fnd� �� 12-4�1"9 ��: 4/�av"�{112 T�tpe� t�es�hrd_��xi,raEe} 8ga. A�Idr�: �8Z�1 d M ST� . �12-�1-� [�e: _ ��ta�: ��r iwn 6iae�t� fi��: �red�c!�ltad ash#cs�_ 3re� " �� _ � � � `��%�� T J ��'��.�Z�� -��t� �5 � � • � � � � <�� c1.L�, �`-e- �'� ' �'e'` .E.�S t� � �� ~ �� 5 �� `�`� � , � � � � ; � � � i � � � � � � � �..�� _._ �m _ __.�.�__ � _ __�____�_�_ � __ .__� ___�._�� ._______._____._______.__ .ri ; �� ; :_.�.�__.�._�. ____��_�__�.��___��---_._______________..�.�_._�...__�.___ .� � _ � �___�_ _._ _�._�___ _�__�____._ _�___� �: �� _ ��_ _ M_ � _