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Old Meter Number ���� q��
Old Meter Reading � ���
Replacement No. � �
Replacement Reading
Replacement Make ������-
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, place ERT
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�., Remarks: ��`� �4-'��"`�
Signed ���5 �o"""�-
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� (��'�� INSTALLATIONr��
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�.NOF AUTOMATIC METER READER
FRIDLEY
Address ��1�� �J�-Z.I,��C��
Name�!h ��AC }�
Date �f ' lL` ��
Old Meter Number �• �
Old Meter Reading ��
Replacement Na �'"-��E`" ����5 �
Replacement Reading �
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Replacement Make��
ERT# `,��,� _Z� ��j �,,�
Replacement ERT#
Remarks:
��5.� Signed:
City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
�fWe hereby authorize the City of Fridfey and/or its
employees to do what is necessary to replace the water meter. 1 understand that the p�operty owner
is liab{e for the water line from the main to the premise and ali interior ptumbing. (Per City code
4p2.06} I also hold the City of Fridiey and/its employees harmiess for any dama�es that may occur
while doing this operation. This to include,but not fimited to;vaives,piping,wafis,floors or the curb
stop box and service line. I understand{anri also required to obtain a permit prior to any wark,if
necessary. � ��
Final metes reading(old meterj_____��_ `
Name�
Address: �� ` { `v�`(.�x"'l��
Phone Number ate: ���~ '�
� Signature: � �L�� �� ` �
Wit�ess 5ignature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER ,
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shal{be required to obtain a permit for such
connection,and shatf pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shalf be notified. it shafi lie unlawfuf to cvver any connecting line unti{an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
propec and suitable connection.
402.06.REPAIRS AND MA{NTENANCE TO CONNECTION
After the initlal connection has been made to the water service curb stop box or the sewer fead at the property
fine 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 liable for all repairs required to any water line and sewer tines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance secvice or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, inciuding any necessary street repairs,at a rate set annually by an administrative
paticy. It shafl be the responsibility of the applicant,owner,accupant ar user to perform standard maintenance of
• the sewer service fine from the premises to the main including debris clearing flr root cutting and to maintain the
water service curb stop box for operability and at such height as witi ensure that it remains above the finished
grade of the land or property. (Ref 638,1156, 1191)
�equest fc�r,�ervic� R�
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