Meter Swap ��`-'"�'''�� —`f�%�C:.�s�
� �'���INSTALLATION
'
c�.noF AUTOMATIC METER READER
FRIDLEY
Address_{��"l— �/�R� ��
Name � O��`,T �;���y_
Date �`��`��
Old Meter Number
Old Meter Reading � �
Replacement No. �4�m���f�sSS �O4
Replacement Reading
Replacement Make p
ERT# ��� a,� �C7
Replacement ERT#
Remarks:
��.,�g Signed:
,, � �t�q��t f�r�ervi� F��p�rt
City a�f Fnd�
� 1Wc�. ��-1 �+e: 4l'�3d��12
F� Tj�e= h�'a��IR nre�ec �r:
E�ep�: Y1lat�r ��e� f�J�t�i+d�g'
Ad�_ ��/►1�E!� � �7"3-2��5
��. C`,�3r�2 ,�-�� �1;u�� �
� ��_ �
���=
�t�id �e�r# �j C� �(��
�id r�din�� �, �j����
[U�w �Ae�r # ���r
���v� ��adin�� �
�
�
���� ��� a� o�
�
�__����_� � ___ ._�__� __�_.__��_��� �________ �__�..�_ �___ ___ _ _____
���: ;
R
�_� _____�.._.__ _ ..�___...._
_ � � � ��
���: 5v3�� ���
a
f •
City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
1/we hereby authorize the City of Fridiey andjor its
empioyees to do what is necessary ta replace the water meter. I understand that the property owner
is liabfe for the water line from the main ta the premise and ali interior ptumbing. (Per City code
402.06j f afso hold the City of Fridiey and/its employees harmless for any damages that rriay occur
while doing this operation. This to include,but not fimited to;valves,piping,walls,floors or the curb
� stop bax and service line. 1 understand i am afso required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meterE I' �
Name: Address: �'�✓� � '�/�� ���
Phone Number: Date: � J���` -
Signature: .
� e
Witness Signature: t�J`�-
FRIDLEY C17Y CODE
CHAPTER 402.WATER,S70RM WATER,AND SANITARY SEWER
ADMINISTRATION
�Ref Ord No 113,464,565,566,624,638,66�,922,988,1144,1156,1191)
402.05. PERMiT FEE �
Prior to constructing or repair of any water or sewer 4ine conneeting the existing municipal system and any house
or building for which the application is made,the owner or contractor shalt be required tu obtain a permit for such
conneetion,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connectian has been
made,the Water and Sewer Department shall be notified. It sha41 be uniawful to cover any connecting 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 cannection.
;
402.06. REPAIRS AND MAfNTENANCE TO CONNECTION
After the initiel 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 lead has been extended to the property line for connectio�,the applicant,owner,
or the occupant or user of such premises shalt be liable for ail repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. tf the property owner requests
maintenance service or repai�s be performed by the City,the property owner shatl be charged for the casts of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. lt shail be the responsibi{ity of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris cleari�g or root cutting and to maintain the
water service curb stop bax for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)