Meter Swap .�- .,�
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citp ot Fridiey
Water DeDartment
Address b� 1 � ��V1 (`O Q J�
Name ' `�O�-� �/��
Date ��� � "' (� ��t{
Old Meter Number '"� � ��� ?
Old Meter Reading �� � � �b
Replacement No. 3 � �.0 �
Replacement Reading �
Replacement Make `J�•L'r
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Remarks: �'
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Signed
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I STALLATION
G.n,� AUTOMATIC METER READER
FRIDLEY
Address ��1 �.�.�13�
Name I ,\�l����1�
Date _ —���- ��l
�
Oid Meter Number � l
Old Meter Reading � � l(7
Replacement Na S
Replacement Reading �
Replacement Make fZ��lv�
ERT# ��,�� �,c�l.� �
Replacement ERT#
Remarks:
g Signed: �
�y'�
.. R���t f�r�nri+� F�
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t�Tj�pe� i��eter �:��:: Wen�y
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C�Id �'le#�r # �J� C� ���
�I�i r+�din�: � � ��'� l�
New �e�r# �A�
P�e�v ��ading. �
E�-�� �-��� 1 a�
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L .
- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
empiuyees 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
402.06j i also hold the City of Fridley and/its employees harmless for any damages that may occur
while daing this operation. This to include,hut not limited to;valves�piping,walls,floors or the wrb
stop box and service line. I understand I am also required tu obtain a permit prior ta any work,if
necessary.
Finai meter reading(old meter) � ` ��� ��
Name: Address: `���` QN""
___..--
Phone Number: pate: ��� � •
,
Signature:
_ Witness Signature:
FRIDLEY CI7Y 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.PERMlT 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 shall be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter li of this Code. After such connection 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 su�h connection and the work incident thereto has been approved by the City as a
praper and suitable connection.
402.05.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connecfiion 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 ihe occupant or user of such premises shall he liable for all�epairs 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 shali be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a raCe set annualty by an administrative
policy. It shail 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 or property. (Ref 638,1156,1191)