Meter Swap �.:'��lS-'`t`��7'7��;
� �'�"��� �INSTALLATION
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G.n� AUTOMATIC METER READER
Fwa�r �,J
Address � � 11 LC�-'('c.�"��,�
Name ��< ��1.��:"'�
Date � r�` � �"��
Old Meter Number �_
Old Meter Reading r �~
Replacemer�t No. ��� �3�� ��
Replacement Reading �
Repiacement Make
ERT# �� � �
Replacement ERT#
Remarks:
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Signed:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridtey and/or its
empioyees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line from the main to the p�emise and all interior piumbing. (Per City code
402.06) I aiso hold the City of Fridiey and/its empioyees ha�mless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walis,floors or the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Ftnal meter reading(old meter) r �� �
Name: Address: ��U� �e��'�`�� ""—�� - —
Phone Number• Date� 1 � ���` —
Signature•
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION `
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191)
402.05. RERMIT fEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or Iruilding for which the appiication is made,the owner or contractor shall be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shail 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.
402.06. REPAfRS AND MAfNTENANCE TO CONNECTtON
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
fine or a water service or sewer lead has been extended to the property line for connection,the applicant,ownec,
or the occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines
necessary for connection of 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 shail 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 shail be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
� the sewer service tine from the premises to the main inc{uding debris ciearing 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)