Meter Swap '� �---c�`� �lGi���S�y��a��
� � INSTALLATION
�.n� AUTOMATIC METER READER
FRIDLEY
Address ���� ' tC?`1� �-
Name ��I��,L.�� �ACL�-c��
Date� � . ' - _ .:��
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Old Meter Number t� . ��
Oid Meter Reading �
Replacement Na f��-�
Repfacement Reading �
Replacement Make �.
ERT#�� � C� �.�_`�
Repfacement ERT#
Remarks:
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 Fridley and/or its
employees to do what is necessary to replace the water meter. I understand that the property owner
is liabfe for the water line fram the main ta the premise and all 9nterior plumbing. �Per City code
402.06) i also hold the City of F�idley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,6ut not limited to;valves,piping,wa(is,flours or the curb
stop box and service line. I understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter� � � �� ��
Name: Address: �0�� ��`�
Phone Number: Date: �_ �`� �� .
Signature:
. Witness Sig e: F 1L�"" 5 �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STQRM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,4fi4,565,566,629,538,662,922,988,1144,1156r 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the appiication is made,the owner or contractor shall be required to obtain a permit for such
connection,and shail 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 shali be uniawful 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 and suitable connectian.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the propefty
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 line and sewer lines
necessary far connection of the premises from the main to the premises. tf the property owner requests
maintenance service or repairs be performed by the City,the property owner shal�be charged for the costs of the
maintenance and/or repairs, including any necessary st�eet repairs,at a raCe set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar user to pe�form 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 operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)