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Water Department �
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. Address , _ _
I Name �/ g �� 0 K' , _
', Date r / �1 / �� . , _
Old Meter Number �7 � ,�� a--0 b �
; Old Meter Reading � � -
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Replacement No. 9 � ,
Replacement Reading � �
; Replacement Make `Z�-�
. . , Remarks: �/`��S�P� Le� �8+�, _
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Signed '
� 0���IN TA��ION���
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u�nroF AUTOMATIC METER READER
FR[DLE.1C
Address��� 2`) �����
Name ��lC� �l��k L�'j'S�.�1
Date �� ��
Old Meter Number `t��.
Old Meter Reading - �,
Replacement No._'`�v� �� �-�-'�
Replacement Reading C�
Replacement Make `.�.)res��
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridtey,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. 1 understand that the property owner
is liable for the water line from the main to the premise and af{interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this ope�ation. 7his to include,but not limited to;vaives,piping,wails,floors or the curb
stop bax and service line. 1 understand i am also required to obtaln a permit prior to any work,if
necessary.
Final meter reading(otd meter) _ ` , ������" "'
.
Name�
Address: � ��
Phone Number� � Date� �� ^ �
Signature: �
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WA't'ER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156,1191)
402.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipai system and any house
or building for which the app{ication is made,the owner or contractor shall be required ta 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 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 the City as a
proper and suitab{e connection.
402.06.REPAIRS AND MAINTENANCE 70"CONNECTION
After the initial connecCion has been made to the water service curb stop box oc the sewer lead at the property_
line or a water seroice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shali be liable for all repairs required to any water line and sewer lines
necess�ry 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 praperty owner shali be charged for the costs of the
maintenance and/or repairs, includin�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 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 wiN ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191�
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