Meter Swap � ���f v I STA�LLAT ON4�
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GNOF AUTOMATIC METER READER
FRIDLEY
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Address ��� �.J � ��
Name �,��L� �,��t-��a+f��
Date ���(;�
Old Meter Number �1�,� ZJ�
Old Meter Reading c
Replacement No. �"� �z�� �
Replacement Reading �
Replacement Make �
ERT# ��1,� �� ��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)57Z-3566
��We hereby authorize the City of Fridley and/or its
employees to do what is�ecessary to repiace the water meter. I understand that the properly owner
is liable for the water line from the main to the premise and atl interior plumbing. (Per City code
402A6) I also hold the City of fridley and/its employees ha�mless for any damages that may occur
while doing this operation. This to include,but not iimited to;valves,piping,wafls,floors ar the curb
stop box and service line. I understa�d 1 am also required to obtain a permit prior to any work�if
necessary.
Final meter reading(old meter) �o� y ��O
Name• ' Address• �� 1' `'���� �7`
Phone Number: Date:�—�����
Signature:(..�1..Y.�/t.o LY � �l Y l C7�1/I�,��+�
Witness Signature•
FRIDLEY CI7Y CODE
CHAPTER 4U2.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 any house
or building for which the appiication is made,the owner or contractor shaN 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 connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any c�nnecting 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 connection.
402.06.REPA{RS AND MAINTENANCE TO CONNECTION
After the initial cor+nection has been made to the water service curb stop box ar the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the appiicant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection af the premises from the main to the prem9ses. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibifity of the app{icant,owner,occupant or user to perform standard maintenance of
• the sewer service line 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 heigM as will ensure that it remains above the finished
grade of the{and or property. (Ref 638,1156,1191)