Meter Swap '� �"v��?�;���13�%yJ
� ���' INSTALLATION
G.N� AUTOMATIC METER READER
FRIDLEY
Address IC1�� ���L�l� `�j�
Name ��(,~C� ��l�.c'�i�
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Date - �
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Old Meter Number �_ 4�� �
Oid Meter Reading L q �
Replacement No. � �'�� `�v�
Replacement Reading pS
Repiacement Make ����
ERT# �rz� �� �� �
Replacement ERT#
Remarks: �
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 5543Z
(763)572-3566
I/we hereby autharize the City of Fridley and/or its
empioyees to do whafi 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 all interior plumbing. lPer City code
40Z.06) f also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,6ut not limited ta;�alves,piping,walls,floors or the curb
� stop box and service line. I understand I am also required ta obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) ��� _ ' ��
Name: Address: �� ��
Phone Number: fie: �`
Signatur •
. Witness Sig ature:
FRIDLEY CITY CODE •
CHAPTER 402.WATER,STORM WATER,AND SAN(TARY SEWER
ADMINISTRATION
(Ref Ord No 113,464r 565,566,629,638,662,922,988,1144,1156,1191}
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal 5ystem and any house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shal)pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall 6e 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 t�►e City as a
proper and suitable connection.
4�2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb 5top 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�epairs required to any wate�fine and sewer lines
necessary for connection of the prernises 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 a�d/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
poficy. It shall be the respansibility of the applicant,owner,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 se�vice curb stop bvx for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191J