Meter Swap � ��'} NS ALLATION�'����
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�.�� AUTOMATIC METER READER
FRIDLEY
Address �� ��
Name �,,r� l ��
Date �`�y`��
Oid Meter Number d�
OId Meter Reading � t �, �
Replacement No. �� ������ ��lY
Replacement Reading �
Repiacement Make
ERT# ��� l I�� L�
Replacement ERT#
Remarks:
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� City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
IJwe hereby authorize tbe City of Fridley and/or its
emQloyees to do what is necessary to replace the water meter.' I understand that the property owner
is liable for the water line fram the main to the premise and ail interior plumbing. (Per City code
40Z.06) I also hold the City of Fridley and/its empioyees harml�ss for any damages that may occur
while daing this operation. Tfiis to include,k►ut not limited to;valves,piping,uvalls,floars or the curb
� stop box and service line. i understand I am alsa required to obtain a permit prior to any work,if
necessary. ,
�
Finaf ineter reading(old meterJ ��� ���
Name: Address: �`� ���
Phone Numb : Date: � `-1
Signature•
. Witness Signature:
FRIDLEY C{TY CODE '
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION '
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1141)
402.05. PERMIT FEE '
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the application is made,the owner or contractor shall be required ta obtain a permit for such
connectian,and shall pay a permit fee as provided in Chapter 11 of thisCode. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any conrtecting line until an
inspeGtion has been made and such connection and the work incident thereto has been approved by the Crty as a
proper and suitabte connection. '
4Q2.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water ser�ice curb stop box or the sewer lead at the property
fine or a water service or sewer tead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall he liable for all repairs required to any water(ine and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
' maintenance service or repairs be pertormed by the City,the p�aperty owner shall be charged for the costs of the
maintenance and/or repairs, inciuding any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service iine from the premises to the main including debris clearing 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 finished
grade ofthe land or property. (Ref 638,1156,1191)