Meter Swap f��-� �>>_ -� �c�`�yr;
�� �'�""��� INSTALLATION
G.n� AUTOMATIC METER READER
FRIDLEY _ _-_
(,/�+'� �'(� i`'�,�
Address �J 1' ��SSL °S� `�---'
,�C-C.C\ � 'o
Name �,�1.�� �C�I.L,iS�'�`:�Z.
Date 1�` ��,~ la ___
Old Meter Number � �J1�7��
Old Meter Reading 1 �` � �
Replacement No. �3�'��
Replacement Reading �
Replacement Make r
ERT# � � "1��1
Replacement ERT#
Remarks:
,
��Signed: -
� ' R�ue�# f�r�er�e F��p€�rt
E�y c�f Fnd�
� �: ��-12 �+c: �"31/�1�
T�e� ir�#a�1�Ii�� Es�t fly: �t
. Y�Ta�s Ca�'�e� �jr t�t�r
Ad�: $�Mf�SISS�PI' 1� � �il�-i47-�61
[�e� �1l�12 2-.3A Pii � t3n�wr_
t��arr IJ�ata�: �Uwtais: �INQ� ,
Ac�nn T��
��� ����� �3C� ��`�S
,
+�i� �����,: I(��`t� � �
r���► ����� S��
�r��► �����,�. �
EF�T# ��j�� �� 4 �
��=
_ i
� _ __�._ _________ ________,____.___ _ .__..__ ___ ____ ;..
��= �
, _ __ ._--��_. ~l�-_.
- City of Fridiey
Water Department
6431 University Avenue NE
Fridley, MN 55432
(763)572-3566
���e hereby authorize the City of Fridley and/oc its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water liae fram the main to the premise and all interior plumhing. (Per City code
402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur
white doing this operation. This to include,but nat limited to;valves�piping,walls,floors or the curb
� stap box and service 11ne. t understand I am also required to obtain a permit prior tv any work,if
necessary.
Final meter reading(old meter) � � �� ��
Name: Address:.�,�—W �/, ,�`�S, `5� —
Phone Number: Date: �`��' `� — .
<
5ignature: �'
. Witness Signature: .
fRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADM1NiSTRATION
(Ref Ord No 113,464,565,566,624,638,662,922,988,1144,1156, 1191)
401.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the application is made,the owner or contractor shall be required to obCain 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 shafl be unlawfuV 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 MAINTENANCE TO CONNECTION
After the initial connecCion has been made to the water servite curb stop box nr 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 premises shall he liable for all repairs required to any wate�line and sewer tines
necessary for cannection of ttie prernises from the main to the premises. If the property owner requests
maintenance service or repairs be perFormed by the City,ihe property owner shal{be chasged foc 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 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 operabiliry and at such height as wi{t ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j