Meter Swap �- ��;� 1���-�---��Us�
INSTALLATION
G.�� AUTOMATIC METER READER
FR[DLEY
Address I(���� – �� �(
Name <\�'�E� �)OF-r
Date �-�– ��
Old Meter Number � �'1
Old Meter Reading q �
Replacement No. C-t����S�Y
Repiacement Reading tU
Replacement Make ����
ERT# �� �ZI.�✓
Replacement E RT#
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City of Fridley
Water Department
6431 Universiiy Avenue NE
Fridley, MN 55432
(763)572-3566
1/we hereby authorize the City of Fridtey and/or its
employees to do what is necessary to replace the water meter. I understand that the property owner
is iiable for the water tine from the main to the premise and ali interior piumbing. (Per City code
402.06) 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 limited to;valves,piping,walis,floors or the curb
� stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter� `��
Name: Address: �(,�'�� `" ���� -
Phone Number: Date: '������ .
Signature: ��� "��� _
. Witness Signature: �___ __ �u��,,,� --
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMfNISTRATfON
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or�epair of any water or sewer line connecting the existing municipal system and anj+house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shatl pay a permit fee as provided in Chapter 11 of this CQde. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting Ilne until an
inspection has been made and such cons►ection 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 connectio�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 be liabie for all repairs required to any water line and sewer lines
necessary for conneetion of the premises from the main to 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/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shalt be the responsibility of the appticant,owne�,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 se►vice c�rb stop box for operability and at such height as will ensure that it rernains above the finished
grade of the land or property. (Ref 638,1156,1191)