Meter Swap c��--���—
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City of Fridley
water Department
Address � F �� �7� ��
Name �e b �'a �Ar
Date l � ^�a" �� �
Old Meter Number� g� .
Old Meter Reading � p � �
Replacement No. ��l �j,j Q /
Replacement Reading �
Replacement Make ���er
Remarks:
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� INSTALLATION
v.�oF AUT4MATIC METER READER
FRIDLEY
Address�{ t� " �i��(
Name �C.� 1��'�c�.
Date �m �� ` ��7.
Otd Meter Number 3�Ci
Old Meter Reading �� - �
Replacement No. �� �'�� ��p 4j
Repiacement Reading �
Replacement Make ��`:� ,
ERT# ���� O�d����r
Replacement ERT#
Remarks
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
� (763)572-3566
I/we hereby authorize the C'�ty of Frid{ey andior its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is tiable for the water line from the main to the premise and all interior plumbing. (Per City code
402.06) 1 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,walls,floors or the curb
� stop box and service line. i understand i am also repuired to obtain a permit prior to any work,if
necessary.
Final meter reading(old meterj ��� ����
Name• Address• �,�,�� _ ��� J7
Phone Numbe�: Date: �"'I`�-i 1[T
Slgnature•
. Witness Signature: �� ,�_
FR{DLEY C{TY C�DE
CHAPTER A02.WA'i'ER,STORM WATER,AND SANITARY SEWER
ADMfN1STRATION
(Ref Ord No 113,464,565,Sb6,b29,638,662,922,988, 1144, 1156, 1191)
402.05. PERMIT FEE
Prior tv constructing or repair of any water or sewer line connecting the existing municipal system and any house
or buildi�g for which the application is made,the owner or contractor shail be required to obtain 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 shali be notified. It shail be unlawful to cover any connecting line untii an
inspection has been made and such connection and the work 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 or sewer lead has been extended to the property line for connection,the applicant,ou+rner,
or the occupant or user of such premises shall be liable for all repairs reguired to any water 4ine and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs he 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 annuatty by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris clearing or root cutCing and to maintain the
water service curb stop hox for operability and at such height as wilt ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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