Meter Swap '� � �„�;�( r t�S-�i S��a�k �'�e,�;
� t--'` INSTALLATION
G.�� AUTOMATIC METER READER
Fwa��r ,�
Address �(� "" `-} t ��.
Name �1���(� �,���
Date �� '��`�
Old Meter Number � �C,�
Old Meter Reading � �
Replacement No. . < �Q L
Replacement Reading�
Replacement Make ��'��-'��
ERT# ���� ��lE'��� , '�
Replacement ERT#
Remarks:
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� City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
���ye hereby authorize the City of Fridley and/or its
employees to do what is necessary to repiace the water meter. I 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 ho{d tfie City of Fridtey ar►d/its employees ha�mless fo�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 i am alsa required to obtain a permit prior to any work,if
necessary. � � ���
Final meter reading(old meter)_ 11`
Name- Address• ����� C )��'��—
Phone Number• Date• l�—�'�`
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANfTARY SEWER
ADMINtSTRATtON
(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(ine 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
conneetian,and shait pay a permit fee as provided in Chapte�11 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 such connection and the work incident thereto has been approved by the City as a
proper and suttable connection.
4Q2.06. REPAIRS AND MAI(dTENANCE 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,owner,
or the occupant or user of such premises shaii be{iabie for al{repairs required to any water tine and sewer lirtes
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 shail be charged for the costs of the
maintenance and/or repairs, inc{uding any necessary street repairs,at a rate set annuaUy by an administrative
policy. It shail 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 operabiiity and at such height as will ensure that it remains above the f+nished
g�ade of the land or property. (Ref 638,1156,1191)