Meter Swap '� �i v'� Il Jz-r�-�s���J
INSTALLATION
crmoF AUTOMATIC METER READER
FRIDLEY
Address � � ���1l%��� �:--�''�=- "���i/
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Name '��' ,�����.A
Date �—�Q �' 1�
Old Meter Number �( 1
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Replacement No. �n�c�� `���� ����
Replacement Reading �
Replacement Make ���"�
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Repfacement ERT#
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^ City of Fridley \
Water Department
6431 University Avenue NE �
Fridley,MN 55432
(763)572-3566
{/we hereby authorize the City af Frid{ey and/ar its
empioyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City tode
402.06) 1 also hold the City of F�idley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walfs,flours or the curb
' stop bax and service line. I understand 1 am atso required to abtain a permit prior to any work,if
necessary.
Final meter reading(old meter} ��� � ���
Name: �4.� C�� Address• �� 1���� ��" "'' '�
Phone Number: Date: �[/�v �
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ftef Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1141)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer fine connecting the existing municipa{system and anjr house
or building for which the application is made,the owner or contractor shall be required to 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 sha�l be notified. It shall be untawful to cover any connecting line untif an
inspection has been made and such connection and the work incfdent thereto has 6een approved 6y the City as a
proper and suitable connection.
402.06. REPAtRS AND MAINTENANCE T�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 shatl be iiable for all repairs required to any water fine and sewer lines
necessary for connection of the premises from the main to the premises. If the property awner requests
maintenance service or repairs be performed by the City,the property owner shail be charged for the costs of the
maintenance and/or repairs, inciuding any necessary st�eet repairs,at a rate set annually by an administrative
pa{icy. It shall be the responsibitity 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 operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)