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G.n�,. AUTOMATIC METER READER
FRIDLEY
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Name ���,lSf�. ��iAt��1►7�
Date ���-'L�
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Old Meter Reading `)��
Repiacement No. � � � 1 ����
Replacement Reading �
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Replacement Make �L� ^
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridiey,MN 55432
(763)572-3566
I(we hereby authorize the City of Fridley and/or its
employees�o do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) I also hold the City of Fridley and/its employees harmless 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 1 am atso required to obtain a permit prior to any work,if
necessary. � � �
Final meter reading(old meter� �
Name: Address: ��� ���� �"
Phone Number: Date: ��`"��
Signature:�(.c�
Witness Signature: d���:�1�.�-�
FRIDLEY CITY CODE
CHAP'TER 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 shall be required to obtain a permit for such
connection,and shall pay a pe�mit fee as provided i�Chapte�11 of this Code. Aftec such connection has been '�'
made,the Water and Sewer Department shall be notified. It shail be unlawfui to cover any connecting line untit an
inspection has been made and such connection and the work incident thereto has been approved by the Gty as a
proper and suitable connection. �
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connectioR has been made to the water service cu�b stop box or the sewer lead at the property.
line or a water service or sewer lead has been extended tothe property line for connection,the applicant,owner,
ar the occupant or user of such premises shafl be liable for aN 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 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 annually 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 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�