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�.�,�. AUTOMATIC METER READER
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Address � ��� � � ���,�
Name ���Li[� t��1� -
Date �jr�'c�� �v�
Old Meter Number �"'�
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Old Meter Reading �
Replacement Na � ��
Replacement Reading � _
Replacement Make �
ERT# � 0
Replacement ERT#
Remarks:
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w City of Fridley
Water Departmant
6431 University Avenue NE
Fridley, MN 55432
(763)572-3566
1/we hereby authorize the City, of Fridley and/or its
employees to do what is nec�ssary to replace the water meter. I url�derstand that the properly owner
is liable for the water line frarn the main to the premise and ait inte�'ior p�umbing. (Per City code
402.06) 1 also hold the City of Frid[ey and/its employees harmless for any damages that may occur
while doing this operetion. This to include,but not limited to;valves,piping,walls,floors or the curb
� stop box and service line. I understand 1 am also required to obtain a permit prior to any work,if
necessary. � �
Final meter reading told meter) �
Name: Address: ��� ��
Phone Number: Date: F�''���—�� .
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.a5. PERMIT FEE
Prior to const�ucting or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the application is made,the owner or contractor shall be requi�ed 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 shall 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 connectian.
402.06. REPAIRS AND MAINTENANCE TO CONNECTIdN
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 repairs required to any water fine and sewer lines
necessary for connection of the premises from the main to the premises. lf the property owner requests
maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. It shall be the responsibitity of the applicant,owner,occupant or user to perform standard maintenence of
the sewer se�vice line from the premises to the main including debris clearing or root cutting and to maintain the
wa#er service curb stop box for operability and at such height as wfll ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j