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� �;�-'��'` INSTALLATION
cr.nroF AUTOMATIC METER READER
FRIDLEY
Address ��� ��`�
Name ����1 N�c,`� �,+�►�R�
Date � c�}—� �
Old Meter Number �7 _ �,
Old Meter Reading L �v �
Replacement No. �2��� �
Replacement Reading �
Replacement Make��
ERT# �������
Replacement ERT#
Remarks
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� City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We herehy authorize tfie City of Fridley and/or+ts
employees to do what is necessary to replace the water meter. f understand that the property owner
is liable for the water line fram the main to the premise and aft interior plumbing. (Per City tode
402.06) i also hold the City of Fridley and/its employees harmfess for any damages that may accur
while doing this operation. This to include,but not(imited to;valves,piping,waNs,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)_ � � "O � v�—''
Name: Address:
Phone Number: Date: `�'y�,,�
Signature: ��
. Witness Signature: :
FRIDLEY CiTY CODE
CHAPTER 402.WATEIi,STORM WATER,AND SANiTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,624, 638,662,922,988,1144,1156,1191}
4D2.05. 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 be required to obtain a permitfor such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connectian has been
made,the 1Nater and Sewer Department shall be notified. It shall be unlawful to cover any connecting Vine 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 connectian.
402.06. REPAIRS AND MAINTENANCE 70 CONNECTION
After the initial connection has been made to the water service curb.stop box or the sewer lead at the psoperty
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 liable for all�epairs required to any water 4ine and sewer lines
necessary far connection af the premises from the main to the premises. If the property owner requests
maintenance service or repairs be perforrned by the City,the property awner 5hatl be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annuatly by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar user to perFo�m standard maintenance of
the sewer service line from the premises to the main inctuding debris clearing ar root cutting and to maintain the
water servlce curb seop box for operability and at such height as wiN ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191J