Meter Swap `"�i.;zs-�->=� ?l`��'
'� ����� INSTALLATION
�� AUTOMATIC METER READER
FRIDLEY
Address l�t �� �1f�.i��
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Name �4`� ��C�1...11���:.,�
Date G7��'- ��
Old Meter Number t � � '��j �
Old Meter Readin � � �. 5 0�
Replacement No. _ '� ��55 �C-
Replacement Reading �
Replacement Make � '�
ERT#
Replacement ERT#
Remarks:
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby autharize the City af Fridley and/or its
employees 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 al�interior plumbing. (Per City code
402.06) i a(so hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this aperation. This to include,but not timited to;vatves�piping,walls,floors or the curb
� stop box and service line. i understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter) � � �� `���
Name: Address: �/�(1� �"'"��
Phone Number: Date: ���1� �
Signature: r ��C/ �
_ Witness Signature:
FRIDLEY C{TY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
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 application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shall pay a pecmit fee as psovided in Chapte�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 connecting 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.
4U2.06.REPAIRS AND MAINTENANCE TO CONNECTfON
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
iine or a water service or sewer fead has been extended to the psoperty line for connection,the applicant,owner,
or the occupant or user of such premises shall be liabie for all repairs 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 sesvice or cepairs 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 responsibility of the appiicant,awner,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 height as will ensure that it remains above the finished
grade of the iand or property. (Ref 638,1156,1191)