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� INSTALLATION
�.n,� AUTOMATIC METER READER
FRIDLEY
Address i(���� W 1T��1J��c�
Name ��iZR.�1.� �A�1�1�1'�;fJ
Date � �J ��
Old Meter Number � �Da
Old Meter Reading �"'� �
Replacement No. ��
Replacement Reading �
Replacement Make
ERT# �(�� v��J �C�
Replacement ERT#
Remarks:
��� Signed:
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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 Fridiey and/or its
empioyees to do what is necessary to repiace the water meter. I understand that the property owner
is fiable for the water tine from the main ta the premise and aft interiar piumbing. (Per City code
40Z.06) 1 also hold the City of F�idtey and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walis,floors or the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading�old meter) �� `�� ��
Name: Address:�,Jy` 1A1�i�`����
Phone Number: ��1�t
Signature: �(J
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,56fi,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 anj/house
or building for which the appiication is made,the owner or contractor shaii 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 shai{be notified. {t sha{t be us+lawful to caver eny connecting line unti!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 the initial connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service ar sewer 4ead has beer►extended ta the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for ali 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�r repairs be performed by the City,the property owner shall be charged for the cnsts of the
maintenance and/or repairs, including any necessary st�eet repairs,at a rate set annually by an administrative
policy. it shall be the responsibility of the applicant,owner,occupant or 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 cu�b stop hox fo�operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)