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� �.,��"t�" INSTALLATION
U.N� AUTOMATIC METER READER
FRIDLEY
Address �������-�5��-
Name G �1.�IU�(Z /�k��S�F=
Date I� ���— �ac
Old Meter Number F���� � `.�
Old Meter Reading Q �Q� b0
Replacement No. r�������/
Repiacement Reading �
Replacement Make ���
ERT# ���C���,��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of 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 from the main to the premise and all interior plumbing. (Per City code
402.06) t also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This ta include,hut not limited to;valves,piping,walls,floors or the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
final meter reading(old meter) � �� ���
Name� Address: ��� ���`
Phone Number: Date: �./�`� ,�
Signature• ���%���1� � ��
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATtON
(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 anq house
or buiiding for which the application is made,the owner or contractor shatl 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 Departrnent 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 suitab(e connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box ar the sewer lead at the property
line or a water servi�e or sewer lead has been extended to the property(ine for connection,the applicant,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 of the premises from the main to the premises. lf the property awner requests
maintenance service or repairs 6e 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
po(icy. It shatl be the responsibility of the applicant,owne�,occupant or user to perform standard maintenance of
the sewer se�vice 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 land or property. (Ref 638,1156,1191�