Meter Swap . ; ` .,,.., �
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City of Fri8ley
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Water Department
. Address �S ��� � '�L J`' _
Name C�i l���s �i► r-� , __
Date � � `' 3 � '�j � ,
Old Meter Number / 9 �-
� old Meter Reading �t� Q� S __
Replacement No. � .
Replacement Reading d :
� Replacement Make ,�c.� 'v �
... Remarks: /�l-e.��c�.. �6� 7�6 � , _
Signed
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C�"�� INSTALLATION
v.nroF AUTOMATIC METER READER
FRIDLEY
Address �� V` �� S�
Name �tY2�� �U�
Date �� � ��- ��
.�
Old Meter Number
Old Meter Reading �{ ��
Replacement No. �1C= ��� � Y�_
Replacement Reading �
Replacement Make
ERT# �3����
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 autharize 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 liable for the water fine from the main to the premise and aN interiar plumbing. (Per City code
402.06) I also hoid the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but nat limited to;valves,piping,wails,floors�r the curb
� stop bax and service line. !understand 1 am also required tv obtain a permit prior to any work,if
necessary.
Final meter reading(otd meter)�� - Ll J����
Name: Address: ���� v�� �7
Phone Number: Date: �_l—�\{�
Signature: �—
Witness Signature:
ERIQIEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINlS7RATION
(Ret Ord No 113,464,565,566,629,638,66Z,922,988, 1144,115b, 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 6uilding fo�which the applicatian is made,the awner or contractor shaN be required to obtain a permit for such
connection,and shaif 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 notifled. lt shall be unlawful to cover any connecting line until aR
inspection has been made and such connectian and the work incident thereto has been approved by the City as a
proper and suitable connectian.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box ar the sewer lead 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 shall be liable for alt repairs required to any water line and sewer lines
necessary for connection of the premises fram the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shafl be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annualty by an administrative
policy. !t shal{be the responsibi{ity 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 operahility and at such height as will ensure that it remains abave the finished
grade ofi the land or property. jRef 638,1156,1191)