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UN� AUTOMATIC METER READER
FRIDLEY
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Date �����
O{d Meter Number
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Replacement Reading �
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ERT# ��.����,f
Replacement ERT#
Remarks:
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_ � � � City of Fridley�
Water Department
6431 University Avenue NE
Fridley, MN 55432
(763)572-3566
��We hereby authorixe the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line fram the main to the premise and all interior plumhing. (Per City code
40Z.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 nat(imited to;valves,piping,wafls,flaars or the curb
� stop box and service line. I understand I am also required to obtain a permit prior ta any wurk,if
necessary.
Final meter reading(old meter� �t:y' � � "" `""
Name: Address: ��� �"'���""� —
Phone Number: Date: v��1� •
�--
• Signature:
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402-WATER,STQRM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638, 662,922,958,1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer fine conr+ecting the existing municipal system and any house
or 6uilding for which the application is made,the owner or contractor shall be required to obtain a permit for such
�on+�e��ien,an�shafl-Pa�T��ermit fPP a��ovid d in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. It shafl be unlawful to cover any connec ing�in -��
inspection has 6een made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connectian.
402.06.REPAIRS AND MA{NT�NANCE TO CONNECTtON
After the initial connection has been made to the water service curb 5top box or the sewer lead at the property
line or a water s�rvice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall 6e liable for all repairs required to any water tine and sewer{ines
necessary for connection of the premises from the main to the premises. tf the property owner requests
maintenance service or repairs�e performed by the City,the property owner shall be charged for the costs of the
mainCenance and/or repairs, incfuding any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the sewer service iine 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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)