Meter Swap � .,-�_l�. '�4%�;"'n"y->�j�cci
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� �` INSTALLATION
��.n� AUTOMATIC METER READER
FRIDLEY
Address ILJ� l ���
Name �,,y1J�TT�; N1���-�
Date In-7�'�o�.
Old Meter Number � ` o43d�
Old Meter Reading � �� ��
'SA� i�S
Replacement No. 80�
Replacement Reading �
Replacement Make � ""�,
ERT# ��� r�`) ��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
1/we hereby authorize the City of Fridley andJor its
emplayees to do what is necessary to repface the water meter. I understand that the property owner
is(iable for the water line from the main to the premise aad all interior ptumbing. (Per City code
� 402.06j i aiso hold the City of Fridley and/its empioyees harmless for any damages that may occur
.whife doing this operation. This ta include,but not limited ta;vaives,piping,walls,fioors or the curb
stop box and service line. 1 understand I am also required to obtain a permit priar to any work,if
necessary.
Final meter reading(old meter) ��� � � ��
Name: Address: `t✓��, ���
Ahone Number: D�te: ��' (
Signature:
. Witness 5ignature:
FRIQIEY CtTY COQE
CHAP7ER 402.WATER,STt3RM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Na 113,464,565,566,629,638,652,922,988,1144,1156,1191)
�ry
402.05. PERMfT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system a�d anq house
or building for which the appfication is made,the owner or contractor sha11 be required ta 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 Department shafl be notified. It shall be un{awful to cover any connecting fine until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
praper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initla(connection has been made to the water service curb stop box ar the sewer lead at the property
iine or a water service or sewer lead has been extended to the praperty line for connection,the appiicant,owner,
or the occupant ar user of such premises shall be lia6{e far all�epairs required ta any water fine and sewer lines
necessary for cannection of the prernises from the main to the premises. If the property owner requests
maintenance service os repairs be performed by the City,tfie property owner sha11 be charged for the costs of the
maintenance and/ar repairs, including any necessary st�eet repairs,at a rate set annualfy by an administrative
policy. It shail be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewe�service 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 538,1155,1191}