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Meter Swap / �71 �� ( �FY/„1�+iJ '� �'��� INSTALLATION U.N� AUTOMATIC METER READER FRIDLEY Address L�"�l.,J �- � t� �` Name � '���L ��� Date - e - Old Meter Number ( r t ' Old Meter Reading � Replacement No. r Replacement Reading � Replacement Make �F�uJ�-�'�-- ERT#������ 1 ✓ Replacement ERT# Remarks: s-�-�,} Sianed: , F����ftu�rvit�: R�►r� • Cit�yy t�f Fr�d�/ i� �a: �1-12- ��: sd2�12 T�e� AMR�f+er E�y� �e�t: 11iRFFa�er ��: �+i'�+�rrt Aidd�: 1 �TH h'�'E NE . 7�71-2� Sc�eckied Q�te: 5�121�t'!�1 ' t}�nec� t��: Fieiquea� [Ir�tai�s: Ai�t. � _ +�ld �'let�er# � ��j S ��� t � �!t'�Icl re�cling: ���`��' j� �ev�v �e�r # �7j(� t�j'�(0 � �Ve�r Reading: � � ���� ��� a��� � � � �____� _ __�_ � �____���______�____��_ ____ � ��� � ; � � � � � , � __ _ __��� _ _�____ _ �� �__�___�_��_____ � �: � � � � .�_ � ��-�� �.�_. . I • City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 (763)572-356fi I/we hereby authorize the City of Fridley and/ar its emplayees to do what is necessary to replace the water meter. I understand that the property owner is liable for the water line fram the main ta the premi5e and all interior plumbing. (Per City code 402.06) 1 alsa hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to;valves,piping,wal(s,floors or the curb � stop box and service lir+e. !anderstand I am also required to obtain a permit prior to any work,if necessary. ��� � �, � W Final meter reading(old meter) Address: N Jl�v r"'_, •��"� Name: . Phone Number: Date: � �`�� Signature: _ Witness Signature: FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER,AND SANRARY SEWER ADMINISTRATIQN (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 municipat system and any house or 6uilding for which the application is made,the owner or contractor shall 6e 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. 4�2.06. REPAIRS AND MAINTENANCE TO CONNECTICIN After the initial connection has been made to the water service curb stop�ox or the sewer lead at the praperty 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 1ia61e for all repairs required to any water(ine and sewer lines necessary far cannection of the premises from the main to the premises. lf the praperty owner requests maintenance service or repairs be perFormed by the City,the property owner shafl he charged far the costs of the maintenance and/or repairs, including any necessary street repairs;at a rate set annually by an administcative poticy. It shall be the responsibility of the applicant,vwner,occupant ar 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�