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crnroF AUTOMATIC METER READER
Frun��r
Address � Y��lJ ����
Name � (EV�: �b�7�s
Date �''��—��
Old Meter Number � t�►�c��
Old Meter Readi � �
Replacement No. �ANL�S ��� �
Repiacement Reading �
Replacement Make �
ERT# � J3� C�� � t
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 the City af Fridley and/or its
empfoyees to do wfiat is necessary to reptace the water meter. I understand that the property owner
is liabte for the water line from the main to the premise and al{interior plumbing. (Per City code
40Z.06) t also hold the City of Fridley and/its employees harmless for any damages that may occur
while daing this operation. This ta include,hut not limited to;valves,piping,walls�floors or the curb
� stop box and service line. i understand 1 am also required to abtain a permit prior to any work,if
necessary.
Final meter reading{old meter) � l./ �� � �� <
Name: Address: iC l���.,t�i,�'`
Phone Number: Date:_ `� T�1`��` •
Signature:
. Witness Signature:
FRIDLEY CITY CODE
CHAP7ER 402.WATER,570RM WATER,AND SANf7ARY SEWER
ADMiNiSTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191J
402.05. PERMIT FEE
Prior ta constructing or repair of any water or sewer line conr►ecting the existing municipal system and any hause
or building far which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shalt pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
madQ,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an
inspection has been made and such conne�tion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAIN7ENANCE TO CUNNECTION
After the initial connection has been made to the water service curb stap box ar the sewer lead at the property
line or a water service or sewer lead has been extended to the praperty line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water tine and sewer(ines
necessary for connection of the premises from the main to the premises. 1f the property owner requests
maintenance service or repairs be performed by the City,the pcoperty owner shall be charged for the costs of the
maintenance andjar repairs, lncluding any necessary street repairs,at a rate set annualiy by an administrative
policy. ft shalf be the responsibility of the appticant,owner,occupant or user to perform standard maintenance oF
the sewer service line from the psemises to the main including debris clearing ar root cutting and to maintain the
water service curb stop box for operability and at such height as wi11 ensure that it remains above the finished
grade ofthe fand or property. (Ref 638,1156,1191J