Meter Swap City of Fridiey �� � � � I �
' ~ Water Department
6431 University.Avenue NE � �y"��K��J��
Fridley, MN 55432
763-572-3565
1/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water mete�. I understand that the property owner is liable for the water line from the main to the premise and aii interior
plumbing. (Per City code 402.06) 1 aiso hold the C'Ry of Fridley and/its empioyees harmless for any damages that may oaur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �� ��
Name• Address� ���
Phone Number�����y� `� `� Date �� � ��
�Sig/natur��J/,� �-- �,�/ Witness Signature
Y
OLD METER# ` � ��
�--
, .' !
OLD READING �� �� V"� ����`
NEW METER# —L � ��- �� �"�
NEW READING �
ERT# ��� � V�` `� ,
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 connecting the existing municipai system and ariy house or building for which T,he
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shail be notified. It shall be uniawful to cover
arry connecting line until an inspection has been made and such connectio�and the work incident thereto has been app�o�d by the City as a
proper and suitabie wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service wrb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of such premises shall be Ilabie for ail repairs
required to any water line and sewer lines necessary for wnnection of the premises from the main to the premises. If the property owner
requests mair�tenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mai�rtenance andior
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shail be the responsibility of the applicant,
owner,occupant or user to perform standard maiMenance of the sewer service line from the premises to the main induding debris ciearing 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 flnished
grade of the land or property. (Ref 638,1156,1191)