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Meter Swap � ��' INS ALLAT ON'�� ' x ��.R,� AUTOMATIC METER READER FRIDLEY � Address �<J� ��'�2�� Name� ��1N� �i�1aC,�Si�A Date ��- (p� - __ Old Meter Number � � 1� 'r'-� Old Meter Reading � ,� �� Replacement No._��l�� Repiacement Reading� Replacement Make � ERT# ��C�� P�� Replacement ERT# Remarks �� Signed: • . ' F2eq�st f�r '�rv� R+�pcxt �i#y a�f Fricf� � , �_ �t-�2-�s� ta�: �r�� i��: vNat� �#i�t�: Ch�ne� �: +6�''►�D ST� _ 7�-0468 �e�d t�= �i�7�J�1�1 ��, �r C�wt�er� . �que�t Ueta�s= /li�� A�T�: �I�i �!e#�r# �� `�'� CCy�� I�d r�adir�� t�� `�� a�v ��r#� ��to 1�3� ��U+��nr ��a�lin�: � �EF�T#� �� ` fk �� 7j 1..._. ..:�....__._... _�__"'....._.,......._____._"'.�..._._.._. ..._�___..._.........._....._____„v. � . � �___�__..._._..._........_.._....................____ __...........�..._........._......______.,.._.._...._.........._,........._................_...._..._._.._.._.......__....___�__._...___ " t ^ �.::� � � .....�..�'�` 1 � . :.� . � � � A...._.. _.. _..� � ,...,_._.._.,, City af Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 (763)572-3566 ��We hereby authorize the City ofi Fridley andJor its employees ta do what is necessary to replace the water meter. t understand that the property awner is fiable for the water line from the main to the premise and ail interior plumbing. (Per City code 402.06) t also hold the City of Fridley and/its e�nptoyees harmless for any damages that may occur whiie doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb � stop 6ox and service line. {understand 1 am also required ta abtain a permit prior ta any work,if necessary. t Final meter readin�(old meter) �� _� `� Name� Address: ^l�)L, �l J �� Phone IVumber: Date: ...J`O� l^ �� Signatures . Witness Signature: FRIDI.EY C17Y CODE CNAPTER A02.WA7ER,STORM WATER,AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,555,566,629,638,662,922,988,1144,1156,1191) 402.05. PERMff fEE Prior to constructing or repair of any water or sewer fine connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shail 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 uniawfut to cover any connecting Ilne 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. REPAI[tS AND MAtNTENANCE 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 tine for connection,the appiicant,owner, or the occupant or user of such premises shall he liabie for all repairs required to any water line and sewer lines necessary for connection of the premises from the ma�n to the premises. If the property owner requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of fhe maintenance and/or�epairs, including any necessary street repaics,at a rate set annuatly by an administrative policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of the sewer se�vice line from the premises to the main including debris clea�ing o�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)