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'� �"���� INSTALLATION
G.n� AUTOMATIC METER READER
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Address �G��l V���i��
Name ��Pfi�� ��z-Z'�.
Date 10" i—��
Old Meter Number � � . �' �
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Old Meter Reading � ��� �
Replacement No. ��'''�� ��"� �Y
Replacement Reading �
Replacement Make �
ERT# ��t �
Replacement ERT#
Remarks
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y - City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��WQ hereby authorize the City of Fridley andJor its
empiayees to do what is necessary to replace the water meter, i understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
4a2.06) i aiso hotd the City af Fridiey and/its empfoyees harmtess for any damages that may occur
while doing this aperation. This to include,but nat limited to;vafves,piping�wails,f{oars or the curb
� stop box and service line. I understand 1 arn alsa required to obtain a permit prior to any work,if
necessary. � �
eter �� � �
F�nal meter reading�old m )
Name•
Address:_ � � /
Phone Number: Date: � r`I� •
�
Signature:
. Witness Signature: ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANiTARY SEWER
� ADMIINIS7RATION
(Ref Ord Na 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402A5. PERMIT FEE
Prior to consfiructing or repair of any water or sewer line co�necting the existing municipai system and any house
or building for which the application is made,the owner or contractor shall 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 unlawfut to cover any connecting line until an
inspection has heen made and such connection and the wo�k incident thereto has been approved by the City as a
praper and suitable connection.
4Q2.D6. REPAIRS AND MAfNTENANCE TU CONNECTtON
After the initial connection has been made to the water service curb stop box or the sewer 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�remises shall be liable for all�epairs required to any water line 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 performed by the City,the prQperty awner 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 responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the 5ewer service line from the premises to the main including debris clearing or root cutting and to�naintain the
water service curb stop box for aperability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191�