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Meter Swap � ;✓ �-�� I S�ALLA ON���4✓ ' u-nroF AUTOMATIC METER READER FRIDLEY Address�����` �-�S��a Name ��L r�� `��� � Date ��b' ��. Old Meter Number `� � Old Meter Reading � � a� � �'�� Replacement No. � � Replacement Reading � Replacement Make ��� E RT# �)�� �� 1� 1 t.� Replacement ERT# Remarks: Signed: �?K38� R�qt�st f�ar�rrric�: R�rr� . Ciiy t�f Fri�#� F�f 1�; s��-12-d� �}ate: �r"�4l�it12 Tj�pe� k�a�1W��E+er �*: �t �: t�iabrr Gtsz��ara�e: Pa�i�n Add�s� �1 ABtE ST NIE - � ! _ 7E�5�7-3�Q5 �: �Il�J'lZ �7�30/ki�l �� � t�er: _ � Req���: /�ii�i �Ta�= ��I�d �leter # � �� � �Jid r€��iin+�: p'��� �� � �,1� r��► ����# '-�3�c�3� � ���,� �����,�,. � � ����# ���j�,� � � � � �____._��_._._�� ___._ _. __ � ���= � �._�__ __...�___� __�________��___.._.._._______�_�___________._ i �' � p � 1 � _ _�� �.�U �� -+ , ' City of Fridley Water Department 6431 University Avenue NE Fridley, MN 55432 (763)572-3566 I/we hereby autharize 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 liabie for the water line from the main to the premise and all interior plumbing. (Per City code 40Z.06� I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not(imited to;valves,piping,walls,floars or the curb � stop box and service line. 1 understand 1 am also required to obtain a permit prior to any work,if necessary. Final meter reading(old meter� ���`� � �� Name: Address: �n��, �,x� �� Phone Number: Date:�'�5.,�^(� • Signature: �� . Witness Signature: , FRIDLEY CITY CODE CNAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156, 1191J 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 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 unlawfut to cover any connecting I+ne until an inspection has 6een made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 4U2.06. 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 6e liable for all�epairs required ta any water line and sewer lines necessary for connection of the premises from the main ta 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/ar 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 pe�form 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 ar property. (Ref 638,1156,1191j ,, <:,,