Meter Swap '= ���1 l �(�'��i S'�l 7i�
INSTALLATION
G.N� AUTOMATIC METER READER
FRIDLEY
Address ����� `� l��
Name ��� ����^��
Date�I�3-- (�
OId Meter Number � �`1 �
Old Meter Reading � v� ��
Replacement No. ��
Repiacement Reading �
Replacement Make r��'�'�
ERT# ����� ✓
Replacement ERT#
Remarks:
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City af Fridiey
Water Department
6431 University Avenue NE
F�idley,MN 55432
(763)572-3566
�iwe hereby authorize the City of Fridiey and/or its
employees to do what is necessary to replace the water meter. I understand that the property owner
is tiable for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) I also hold the Gty of Fridley and/its employees harmiess for any damages that may occur
whiie doing this operation. This to inciude,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. 1 understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter�
Name• Address• ✓�� '"���5/ --
Phone Number. Oate: 1 J``( �+��
5ignature:
IMtness Signature:
FRIDIEY CITY COOE
CHAPTER 402.WATER,S70RM WATER,AND SANiTARY SEWER.
ADMINISTRATION
(Refi 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 buiiding fo�which the application is made,the owner or cantractor shall be required ta 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 shall be notified. It shall be uniawful to cover any connecting line until 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 CONPIECTiON
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,owner,
or the occupant or user of such premises shail be liable for aff repairs 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 perfarmed by the City,the property owner sha{I be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annualfy by an administrative
policy. It shali be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
• the sewer service fine from the premises to the main including debris ctearing 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)