Meter Swap '/ �� Pv l✓a-'�:S-'�'j G�5(�ti
� ����- � ° INSTALLATION
c�.noF AUTOMATIC METER READER
FWDLEY ��1 .
Address � �I�J �A�� "
Name I�A'l..`�t� (v)����
Date IG'� [�"��
Old Meter Number "[ g C�`'7
Old Meter Reading � t
Replacement No._���'�'��5�
Replacement Reading �
Replacement Make ��' '
ERT# �
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Frid4ey,MN 55432
(763)572-3566
EiWe hereby authorize the City of Fridiey and/o�its
empioyees to do what is necessary to replace the water meter. i understand that tfie property owner
is liable for the water line from the main to the premise and atl interior plumbing. (Per City code
402.06J 1 also hold the City of Fridley and/its employees harmtess for any damages that may accur
whife doing this operation. This to include,but nat limited to;valves,piping,walis,floors or the curb
stap box and senrice tine. i understand i am aiso required ta obtain a permit prior to any work,if
necessary.
Finai meter reading(ofd meter�
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Name• Address•_ YV��`� � �- �
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Phone Number: Date: �J"(�"�'L
Stgnature: �
. Witness Signature:
FRIDLEY Ci'iY CODE
CHAPTER 402.WATER,STQRM WATER,AND 5AN[TARY SEWER
ADMlNISTRATION
(Ref acd Na 113,464,565,565,629,638,662,922,988,1144,1156,1191}
4d2.05. 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 application is made,the owner ar contractor shall be required to abtain a permit for such
cannection,and shall pay a permit fee as pravided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. ft shal{be unlawfu{to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAfNTENANCE TO CONNECTION
After the initia!connection has been made to the water service curb stop box or the sewer Iead at the property
fine or a water service or sewer lead has been extended to the property{ine for connection,the applicant,owr►er,
or the occupant or user of such premises shatl be liable far ai{�epairs requi�ed to any water(ine and sewer lines
necessary for connection of the premises from the main ta the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shal{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 sha{{be the responsibitity of the app{icant,awner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris ciearing 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 of the land or property. (Ref 638,1156,1191)