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INSTALLAT{ON
�.��. AUTOMATIC METER READER
Ftin��r
Address � ,���'� — ���� ��
Name Z�C—"� �3�''�C���
Date �i�' '�
_ ^
Old Meter Number ' �4 �
Old Meter Reading �
Replacement Na '��t,�,Q,�� �c U�y
Replacement Reading �
Replacement Make �
ERT# ��� �U a�('l
Replacement ERT#
Remarks:
7�.�� Signed:
. ����f�cuu�r� Fi�►�
' �ii�yy of Fri�i�y
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C�I�i r��din�: Q �Q�CS 3�f.C�
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�1��r �ea€iinc�. (�
E�T� �'��a�d�
.
��'� �__.... ---------..�__. .. _.__----�.._ ._________.._._.___-------
�� � ._.�_._ ________ .___________.._. _..�.__ �____ ___..______.._
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.
City of Fridley
Water Department
6431 Universify Avenue NE
�ridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridiey 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 all interior plumbing. (Per City code
40Z.06) i also hold 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,walis,floors or the curb
stop box and service line. i understand I am also required to obtain a permit prior to any wark,if
necessary.
Final meter reading�old meter� l J �� ���
Name• Address•r �� � v�� '7`��
Phone Number: Date:��`-1 v`
�
Signature:
. Witness Signature:
� FRIDLEY CITY C�DE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADM1NfSTRATiON
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156,1191)
402.05. PERMIT FEE
Prior to const�ucting 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 shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Departrnent shall be natified. it shall be unlawful to cover any connecting line until an
inspection has been made and such cor�nection and the wark 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 lead has been extended to the property line far connection,the applicant,owner,
or the occupant or user of such premises shall 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 shall be charged for the costs of the
maintenance and/or repairs, including 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 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 curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land ar property. (Ref 638,1156,1191)