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� INSTALLATION
unroF AUTOMATIC METER READER
FRIDLEY
Address � CS'
Name O�{.3�� ��T�1���
Date b` �'l`i t�
Old Meter Number 5S �b 1*
Old Meter Reading � b ���d
Replacement Na SA�+� ��� �x�,N.
Repiacement Reading �
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Replacement Make
ERT#
Replacement ERT#
Remarks:
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- City of Fridley
Water Department
6431 Unirrersity Avenue NE
Fridley, MN 55432
(763)572-3566
t/we herehy authorize the City of Fridley and/or its
employees 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 premise and ail interior plumbing. (Per City code
402.06) I also hold the City ot Fridley and/its employees harmless for any damages that may occur
while daing this operation. This to include,hut not limited to;valves,piping,walls,floars or the curb
stop box and service line. I understand t am also required to obtain a permit prior to any work,if
necessary. �
r ` �l 6� 6
F�nal meter rea�ins(�I�mete �
Name• Address•_ ��� ���
Phone Number: Date: �v���`
Signature:
Witness Signature: �''�
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,4fi4,565,566,629,638,662,922,988,1144,1156,1191�
402.05.PEtiMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anj+house
or building for which the appiication 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 shall be noti�ed. It shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the wark incident thereto has been approved by the City as a
proper end suitable connection.
402.06. REPAiRS AND MAfNTENANCE TO 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 shall be liable for aii repairs required to any water line and sewer lines
necessary for connection of the prernises from the main to the premises. If the property owner requests
maintenance service or repairs he perFormed by the City,the property owner shall 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 shall be the responsibility of the applicant,owner,occupant or user to perform standa�d maintenance of
the sewe�service line from the premises to the main inciuding 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)
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