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�.�,oF AUTOMATIC METER READER
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Name �Sr(P�_�e�t.�r
Date �'-3�-1�
Old Meter Number ��
Old Meter Reading
Replacement No. �9�
Replacement Reading �
Replacement Make �
ERT# �3����� ✓
Repiacement ERT#
Remarks:
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Gity of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I jwe hereby authorize the City of Fridley and/or its
emptoyees ta do wfiat is necessary to replace the water meter, i understand that the property owner
is liable for the water tine from the main to the premise and ali interiar plumbing. {Per City cvde
402.06) i also hold the City of Fridfey and/its employees harmless for any damages that may occur
while doing this aperation. This to inciude,but not Iir►�ited to;vatves,piping,walls,floors ar the curb
stop bax and service line. 1 understand 1 am afso required to obtaln a permit prior to any work,if
necessary. -
Final meter reading(old mete�j �lLJ�1,�� �lJs���
Name� x✓ �� Address:�')�� ���""�
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Phane Number: Date: .l "��
Signature:
. Wltness Signature: �""^�
FRIDLEY CITY COOE
CHAPTER 402.WATER,STt3RM WATER,AND SANiTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566, 629, 638,662,922,988,1144,1156,1191�
4d2.05. PERMIT FEE
Priar to constructing or repair of any water or sewer line connecting the existing municipat system and any house
or building for which the applicatian is made,the owner or contractor shall 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 cannection has been
made,the Water and Sewer Department shait be notified. it shall be unlawfuf to cover any connecting line untii an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
praper and suitable connection.
402.06. REPAIRS AND MAtNTENANCE TO CONNECTlON
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 tead has been extended to the property line for connection,the appticant,owner,
or the occupant or user of such premises shall be liable far all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. {f the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the casts of the
mainte�ance and/or repairs, including any necessary st�eet repairs,at a rate set annually by an administ�ative
poticy. !t shall be the respansibi{ity of the applicant,owner,occupant ar user to perform standard maintenance of
° the sewer service line from the premises to the main including debris clearing or raot cutting and to maintain the
water service cur6 stop box for operability and at such height as wiil ensure that it cemains above the finished
grade of the land or property. (Ref 638,1156,1191j