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'� �' INSTALLATION
GTYOF AUTOMATIC METER READER
FRIDLEY
Address �(`,L,��� ���'�
Name �C:�� �P.G��-'�f
Date �`�'—��►l�
Old Meter Number ��� C�J�
Old Meter Reading ��
Replacement No. ��
Replacement Reading � _ _ _
Replacement Make L��-l.�
ERT# � 1 �� � 1 � �
ReplacementERT#
Remarks:
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- City of Fridtey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572•3566
I/we hereby authorize the Ciiy of Fridley and/or its
employees 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 code
402.Q6� i aiso hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. 7his to include,but not limited to;vatves,piping,walls,fioors or the curb
stop box and service tine. 1 understand I am alsa required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) ���� ��� .�,t_
Name•
Address: ��� ( � ` I� �
Phone Number� Date: ��`����
Signature:
Witness Signature:
FRIDIEY CtTY CODE
CHAPTER 40Z.WATER,STORM WATER,AN�SANITARY SEWER
ADMlNlSTRATIUN
(Ref Ord No 113,464,5fi5,566,629,638,662,922,988, 1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipai system and any house
ar 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 shali be notified. It shal!be unlawful to cover any connecting i�ne 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.REPAIRS ANO MAINTENANCE TO CONNECTION
After the initiat connedion 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 e�ctended to the property line for connection,the appticant,owner,
or the occupant or user of such premises shatt be liable for all repairs required to any water line and sewer lines
necessary fo�connection of the premises frorn the main to the premises, tf the property owner requests
maintenance service ar repairs be performed by the City,the property owner shatl be charged fur the costs of the
maintenance and/or repairs, inctuding any necessary street repairs,at a rate set annually by an administrative
po(icy. It shatl be the responsibility of the applicant,awner,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 operabiiity and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,2156,1191)