Meter Swap ,s`.y, �t .t� .w �'�'�"s )�".
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City ot Fridley
Water Denartment
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Name 1 ACl��� �s�..��-
Date ���"(�
Old Meter Number ��
Old Meter Reading �
Replacement No.��3"i �CZ-=-
Replacement Reading_
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Replacement Make ��.
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v.�� AUTOMATlC METER READER
FR(DLEY
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Date �7'6�,\— l�
Old Meter Number 1 ���
Old Meter Reading � �
Replacement No. r.��v1��� �
Replacement Reading �
Replacement Make unW `� ,
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Replacement ERT#
Remarks:
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City of Fridfey
Water Department
6431 University Avenue NE
Fridley, MN 55432
(763}572-3566
�rWe hereby authorize the City of Fridley and/or its
employees to do what is necessary to reptace the water meter. f understand that the property owner
is liable for the water line fram the main to the premise and all interior plumhing. (Per City code
402.06j 1 also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but not fimited to;valves,piping,wa{Is,floars ar the curb
stop box and senrice line, f understand i am also required to obtain a permit prior to any work,if
necessary.
final meter reading(otd meter} � J '� �� ��
Name• Address• ����
Phone N be • Date: L')'m��`�
5ignatur •
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STQRM WATER�AND SANITARY SEWER
ADMINISTRATfON
(Ref Ord No 113,464,565,566,6�9,638,66�,922,988.1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing ar 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 sha11 be required to obtain a permiC for such
connection,and shal)pay a permit fee as provided in Chapter 11 of this Code, AfCer such cannection 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 conne�tion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.05. REPAIRS AND MAtNTENANCE TO CONNECTlaN
After the initiai connection has been made ta the water service curb stap box or the sewer lead at the property
line or a water senrice or sewer tead has been extended to the property line for cannection,the applicant,owner,
or the occupant or user of such premises shall be iiable fior al1 repairs required to any water{ine and sewer{ines
necessary for connection of the premises from the main ta the premises. lf the property owner requests
maintenance service or repairs be performed by the City,the property owner shatl he charged for the costs of the
maintenance and/or repairs, incfuding any necessary street repairs,at a rate set annually by an administrative
palicy. !t shall be the responsibility of the ap}�licant,owner,occupant or user to perform standard maintenance of
the sewer service line firom the premises to the main including debris clearing ar 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(and or property. (Ref 638,1156, 1191j
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