Meter Swap � ���'� INSTAL TION �
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ca.noF AUTOMATIC METER READER
FRIDLEY
Address {n`(c I' �� +,Z��
Name ��('-�(Z ��`L�5�
Date �'�—��
Old Meter Number 1('
Old Meter Reading � �
Replacement No. < ���pp�/
Replacement Reading c�
Replacement Make � �
ERT# ��� c�clG��� `
Replacement ERT#
Remarks:
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- City of Fridfey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(7fi3)572-3566
��We hereby authorize the City af Fridley and/or its
employees to do what is necessary to repiace the water meter. I understand that the property owner
is liable for the water line fram the main to the premise and all interior plumbing. (Per City code
40Z.06) I a(so hold the City of Fridley and/its employees harmless for any damages that may occur
while doing tfiis operation. This to inctude,but nat limited to;valves,piping�walls,floors or the curb
� stap box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary. � -:
Final meter reading f old meter) �
Name: Address: .����1 � ���� —
Phane Numb r: . Date: � —� - •
1 .
Signature:
_ Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMIfM1STRATtON
(Ref Ord No 113,464,565,566,624,fi38,662,922,988,1144,1156, 1191)
402.05.PERMtT FEE
Priorto constructing or repair of any water or sewer line connecting the existing municipal system and any house
or buiiding for which the application is made,the owner or contractor shall 6e required ta obtain a permit for such
connection,and shall pay a permit fiee as provided in Chapter 11 of this Code. After such connection has heen
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the C�ty as a
proper and suitable connection.
402.05.REPAIRS AND MAtNTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewec lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liabte for all�epairs required to any wate�4ine ar►d sewer tines
necessary for connection of the prernises from the main to the premises. If the property awner requests
maintenance se►vice or repairs be performed by the City,the property awner shali be charged for the costs of the
maintenance and/or repairs, including any�ecessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar use�to perform standard maintenance af
the sewer se�vice line from the premises to the main including debris clearing ar root cutting and to maintain the
water service cur6 stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,i156,1191)