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� INSTALLATION
�.�� AUTOMATIC METER READER
FRIDLEY
Address ��,1�7�.i "` �T'—���T
Name ��„��laf �-!-"�X�
Date �o�—��''�(
Old Meter Number � r ���
Old Meter Reading Q � � ��
Replacement No. `��'�*�l� ��``>��
Replacement Reading C�
Replacement Make ��t��.
ERT# ��t� ��C�� ��
Replacement ERT#
Remarks:
7�3 Signed:
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City of Fridley
Water Department
6431 University Avenue NE
Ftidley,MN 55432
(753)572-3566
��We hereby authorize the City of Fridley andjor its
employees to do what is necessary to replace the water meter. 1 understand that the properly owner
is liable for the water line ftom the main to the premise and afl interior p{umbing. (Per City code
402.06) 1 aisa hold the Caty of Fridley and/its employees harmtess for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. i understand i am also required to obtain a permit prior to any work,if
netessary.
Final meter reading(old meter) � ` f� ��
Name• Addsess: �v � �*
Phone Number Date: ��'�t�—��
�"�, i��
Signature:, '
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WA't'�R,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,63$,662,922,988, 1144, 1156,1191)
402.05. PERMIT�EE
Prior to constructing or repair of any water or sewer line connecting the existing municipaf system and any house
or building fo�which the application is made,the owner or contractor shall be required to ohtain 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 shafl be notified. ft shall be unlawful to cover any connecting{ine untii an
inspection has been made and such connectian and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be iiable for atl repairs required to any water iine 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/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. It shail be the responslbility of the applicant,owne�,occupant or user to perform standard maintenance of
° the sewer service line from the premises to the main inciuding debris clearing or root cutting and to maintain the
water service�urb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)