Meter Swap '� / 4%�4 t�S-�?�?7ci
� li�=�� INSTALLATION
un� AUTOMATIC METER READER
FRIDLEY
Address �'��„ �-\ �J�1F-t��
Name .� �� ��/ri�
Date [ '—�.� "'�nC
Old Meter Number �
Old Meter Reading
Replacement No.
Replacement Reading �
Replacement Make��,�,_�,
ERT# ��% �, ��O c�.. i/
Replacement ERT#
Remarks:
��,�.� Signed:
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' Ci�y c�# Friti�
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. Watex �i�a�e� ��
Ad�: 6�9 A'1i�� . �12��5-0�48
S�d tl��te: 7�"1�11��P�1 �� �jr t�:
_ �r�eat E�ta�7s: 11�
A�T��
+�Id �II�#�;r# ��,n����d�
�Id readin�� �'`j 1 ��'��
N�:r�r �e�r � ��;��
�1+ev�r R�eading: �'
ERT#` ���d o�,��o C�.
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' City of Fridley
Water Department
b431 University Avenue NE
Fridiey,MIV 55432
(763)572-3566
��We hereby authorixe the City ofi Fridley and/or its
emp{oyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabie for the water line from the main to the premise and ail interior ptumbing. (Per City code
4QZ.06) t atsa hald the City of Fridley and/its emptoyees harmless for any damages that may uccur
whife doing this operation. This to include,but not timited to;valves,piping,walls,floots or the curb
� stup box and service tine. I understand I am atso cequrred to abtain a permit prior to any work,if
necessary.
Finat meter reading(old meter) ��� ��
Name: Address: ���� ��"�' "`�
Phone Number: Date: [ `�O ��'� �
� Signature: �
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANiTARY SEWER
ADMINISTRATl1JN
" (Ref Ord No 113,464,565,566,629,638,66Z,922,988,1144, 1156, 1191�
402.U5. PERMI7 FEE
Prior to canst�ucti�g ar repair of any water or sewer line connecting the existing municipai system and any house
or bui{di�g for which the appiication is made,the owner or contractor shall 6e required to obtain a permit for such
connection,�nd shall pay a permit fee as provided in Chapter 11 of this Code. After such c�nnection has been
made,the Water and Sewer Department shall be noti�ed. It shail be unlawful to cover any connecting fine until an
inspection has been made and such connection and the wark incident thereto has been appraved by the City as a
proper and suitable connection.
4�2.06. REPAfRS AND MAfNTENANCE 70 CONNECT{ON
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 iead has been extended to the property line for connection,the applicant,awner,
or the occupant or user of such premises shall ae liable for all repairs required to any water fine and sewer lines
necessary far 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 awner shall be charged far the costs Qf the
maintenance and/or repairs, including any necessary street repairs,at a rate set annualty by an administrative
po(icy. It shall be the responsibitity of the applicarrt,owner,eccupant ar usec to perform standard maintenance of
the sewer service line from the premises to the main including debris ctearing or root cutting asid ta maintain the
water service curb stop box for operahiliry and at such height as will ensure that it remains above the finished
g�ade of the land or property. (Ref 638,1156,1191)