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Meter Swap '� ��ru k�--��4 a�� (��—�'� I STALLATION U.�� AUTOMATIC METER READER FRIDLEY � (,�� Address <-��J �'��'�C�� Name��l�l'nQr� �l_1,C.�� Date t��— �`1 "'-�� Old Meter Number �Ca�� Old Meter Reading � �� Replacement No. ""�� i �3 Replacement Reading � Replacement Make �� ERT# � J 7lJ �`I�C� V Replacement ERT# Remarks: �� Signed:, • f��q�# f��e - R�pr�►r# �i#y a�f F�icite� � , t�: s��t-�rt- ��: t��2�.r�t� �T�� t�� r: �. ta� � �v�� . � �� wa��r+�`��r t� . ��-s�s-�o� ��: .v"�: .�LI'�� 1 JNfi!"./� W� � . � . V� ��: '�'��: ��Rt • ,�1�i�K�F"dl'� ; I�� r � � � � � � � � f L L=--�'t�`Z- �— 1 e� 4 �JE7` a � m � � �L-� �--e�� ^ ��S�l C� � �,�-z�z� - � � a� � �� 3 � a � ��, ��,�U�- � , �—�—� �— 3��C�3� 3� � � �� ___ _ __�_ __ ___ ��__ ____ _ �.� �________ ��.___. _________�_____�_ 4 � � �.��_ _�. �.�� ._��.�_�_..�___._.__�_ r . � �.__� _� _____ �..______ _ _�____e�� . �: �--..__._____—_____ �� a ��-� _ � �� . � . 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 necessazy to replace the water meter. I understand that the • property owner is liable for the water li.ne from the mai.n to the premise and all interior plumbing. (Per City code 402.06) I also hold the City of Fridley and/or its employees harniless 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 un.derstand I am also required to obtain a permit prior to any work,if necessary. Name: Address: �-J�?R� ��'�� Phone Number: Date: ��L ��)� Signaiure: Witness Signature:�� - 2�t�� l ��SIQ �� FRIDLEY CITY CODE CHAPTER 4tl2.WATER,STORM WATER AND SANITARY SEWER ADMIN�STRATION (Ref Ord No 113,464,565,566,629,638,662,422,988, 1144,1156, 1191) 402.05. PE1tMTT FEE Priar 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 DepartmenC shall be notified. It sha11 be unlawful to cover any connecting tine until an mspection 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 MA.INTENANCE 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�ctended to th�pruperty line for connection,the applicant,owner,or the occupant or user of such premises shall be liable far all repairs required to any water line and any sewer lines necessary for connection of thie premises from the main to the gremises. If the property uwner requests maintenance services 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,a#a r�te set annually by an administrative policy. It shall be the responsibility of the applicant,owner,accupant or user to'perform standard maintenance of the sewer service line from the premises to the main iucluding debris clearing or root cutting and to maintain the water service curb stop box for operability and at sucb height as will ens�ne that it rennains above the finished grade of the land or property. (Ref 638,1156,1191}