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u.R,� AUTOMATlC METER READER
FRIDL.�.Y .
Address IG.f'%'U'\ ` ����1
Name �'�;"'� +'lC,��=��-��
Date � ��.�- ,,Z.
Oid Meter Number 4 �� �' �
Oid Meter Reading � �
Replacement No. Arn�� ��� ��y}
Replacement Reading �
Replacement Make �.
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Replacement ERT#
Remarks:
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� City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/orits
employees to do what is necessary to replace the water meter, i understand that the property owner
is li�ble for the water tine from the main ta the premise and a!1 interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occue
while doing this operation. This to include,hut not limited to;vaives,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) o��� ��
Name: Address: ,�(/V�.1� ��� —
PhoneNumber: Date: �'"�_.\�
,
Signature:
Witness Signature: �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
: AtDMINISTRATION
(Ref Ord No 113,464,565,566,629,638, 662,922,988, 1144, 1156,1141)
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 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 shall be notified. it shafl 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 the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After th�initiai connection has been made to the water service curb stop box or the sewer iead at the property
line or a water service or sewer lead has been extended to the property line for connection,the appiicant,owner,
or the occupant or user of such premises shail be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shail be charged for the casts of the
maintenance and/or repairs, including any necessary street repairs,at a raee set annualiy by an administrative
policy. It shall be the responsibility 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 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)