Meter Swap .
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City of Fridley �1_�„����v��
Water Department 3
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
I/we hereby authorize the City of Fridley and/or its empbyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and aN interbr
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may acur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,ff necessary.
FINAL METER READING(old meter) �� �� � ��
Name• l`U�Q�� ��)� Address �6�1 �'_�'b�'�, �T
Phone Number ate �—U� 1�
Signature Witness Signature
OLD METER# ��� � l �� SIZE & STYLE ICirclel
OLD READING � r�� ��O 5/8" HEX
NEW METER# ������I�v 1" HEX
.
NEW READING � 1�4" ELiPTtCAI or HEX
ERT# l (,�' �� S�''I�� 2" ELIPTICAL or HEX
FRIDLEY CITY 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)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line wnneding 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 co�nection,aru!shall pay a permit fee as provtded in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawfut to cover
any conneding 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.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water serv�lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shail be iiaWe fw all�rpairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mai�rtenance and/or
repairs,including necessary street repairs at a rate set annually by an admin7strative poliry. !t shall be the responsibflity of the applfcant,
owner,occupant or 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) �;�
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�e�-ice Detaiis 1 I
Date Created # �?Q17-�1?- � Reque�r # 17408 �
Department # �*�R _____ � _ �
Pro6tem�Tssue * �INST.�.L,L�SR l���ER �` (
Requested B} �Marlen� I{ranz ' �
Please Contact i�
Suboutter �
5ubmitter S.�s B�en G�
Cantacted
AiapFeeder Connect (�
�IapFeeder Connect ��
Issue #
Address � �
� Cit;� � �State �— i�IP� 1
Email �
Phone � �
Action �eeded
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