Meter Swap '= ���� f 3�S-`�7�orJ
INSTALLATION
G.noF AUTOMATIC METER READER
'ERIDLEY
Address ����` ( �E--C��.-��.�-�
Name �.r.C�A�� ��`�RT'�t�
Date � l-'��
Q
Old Meter Number �L �
Old Meter Reading �
Replacement No. � � ` �
Replacement Reading �
Replacement Make ~���
ERT# ��� ����� t
Replacement ERT#
Remarks: � (i�1 �.���,�� �
�,�,�� Signed:
F''�t/4T ��
—
UT101IO2 CITY OF FRIDLEY CXLIB 9/17/12
Location Selection 12: 53: 53
Type options, press Enter. . - • '
1=Select 19=Image Docs �,�`,e�
Loeation
Opt ID Location Address ��Meter number
474010 6367 DELLWOOD DR NE ���e.� 91780456
= 449810 6446 ASHTON AVE NE �� � 91780456X
446740 5141 -5143 3 ST NE o ,,,�-� 91780457
i 466260 1340 64 AVE NE 'U`�� 91780458
= 473120 665 CHERI LN NE .'��� 91780460
_ FILTRATION PLANT � :�c 92011850
_ 452600 5250 MAIN ST NE � 92052757
FILTRATION PLANT 92052758
FILTRATION PLANT 92052759
546530 151 1/2 CHRISTENSON CT NE 92053942
546540 6445 1/2 CHRISTENSON LN NE 92053943
METER HEAVEN 92053949
517910 100 OSBORNE RD NE 92053949X
517910 100 OSBORNE RD NE 92053950E
494370 6279 UNIVERSITY AVE NE 92055052 +
F3=Exit F12=Cancel F6=Add new meter
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City of Fridley
Water Department
6431 Universiiy Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridiey andior its
employees to do what is necessary to reptace the water meter. I understand that the propertY owner
is liable for the water line from the main to the premise and all interior piumbing. (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. 7his to include,but not limited to;valves,piping,walls,floors or the curb
� stap box and service line. i understand I am also required ta obtain a permit prior to any work,if
necessary.
Final met r r " (old meter)
Address: ����
Name: .
Phone Number: Date: 13�r,� �
� Signature:
,
. Witness Signature: '"
FRIDLEY CITY CODE
CHAPTER 402.WA7ER,STQRM WATER,AND SANtTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156,1191}
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer tine connecting,the existing municipal system and anq house
or 6uilding for which the application is made,the owner or contractor shall be requi�ed to obtain a permit for such
sert+�ee�Tor�,an�shall-PaTa-^pf mit faP as r vid d in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Depariment shall be notified. It shall be unlawFul to cover any conne ing�e�niii���
inspection has 6een made and such connection and the work incident thereto has been approved by the C"�ty as a
proper and suitabte connectian.
4Q2A6.REPA{RS AND MAINTENANCE TO CaNNECTION
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 occupanC or user of such premises shall be liable for all repairs required to any urater{ine and sewer lines
necessary for cnnnection af the premises from the main to the premises. If the property owner requests
maintenance service or repairs 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
poficy. It shall be the responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the sewer service line from the premises ta the main including debris clearing or root cutting and to maintain the
water service cur6 seop bax for operability and at such height as wil!ensure that it remains above the flnished
grade of the land or property. (Ref 638,1156,1191j