Meter Swap �� �,. J�'i 5�'-`7 G���SZ..�
� U-��J3 INSTALLATION
�.n,� QUTOMATIC METER READER
FRIDLEY
Address (���C91 ' '�����'�
Name � 21,t`� �l�C�.C'�'� _ _
Date �`���
Old Meter Number�
Old Meter Reading - �
Replacement No. M� � �
Replacement Reading �
Replacement Make �
ERT# � ._ � �3�1
Repiacement ERT#
Remarks:
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
t/we hereby authorize the City af Fridley and/or its
employees to du what is necessary to replace the water meter. I understand that the praperty owner
is liable for the water tine from the main ta the premise and atl interior plumbing, (Per City code
402.06� i also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this aperation. This to include,but nat limited to;valves,piping,wails,floors or the curb
stop box and service line. I understand i am aiso required to obtain a permit prior to any work,if
necessary.
Final meter reading(oid meter) � � V ��
Name• Address: ��� � G�'��7
Phone Number: Date: ���!1�
Signature:��3l�n.�-. �,�„��-��-A-,n — -
Witness Signature: ���
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,ANO SANITARY SEWER
ADMINISTRAT{ON
(Ref O�d No 113,464,565,566,624,638,662,422,988, 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 apptication is made,the owner ar contractor shat{be required to obtain a permit for such
cannectian,and shatl pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shatl 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.
402.Q6. REPAIRS AND MAINTENANCE TO CONNECTION
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 premises shall be liable for all�epairs required to any water line and sewer lines
necessary for cannection of the premises from the main to the premises, ff the property owner requests
maintenance service or repairs be performed hy 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 applicant,owner,occupant or userto 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 se�vice curb stop box for operahility and at such height as witl ensure that it remains above the finished
grade of the(and or property. (Ref 638,1156,1191j