Meter Swap '= (j�-ti`-f ���`�:��- y�Sv'�u
INSTALLATION
crnroF AUTOMATIC METER READER
FRIDLEY
Address IC��' ����✓
Name��±Z.�s ���
Date 6�'"�� '�'�
Old Meter Number �C���
Old Meter Reading
Replacement Na -��� �
Replacement Reading �
Replacement Make
ERT# <,�,�����
Replacement ERT#
Remarks:
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City of Fridtey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
�/We hereby authorize the City of Fridley and/or its
employees to do what is necessary to replece the water meter. 1 understand that the proqerty owner
is liabte for the water line from the main to the premise and afl interior plumbing. (Per City cocle
402.06) I�Iso 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,watis,floors or the curb
stap box and senrice line. I understand 1 am also required to obtain a permit prior to any work,if
necessary.
Final meter readin oid meter � �✓�'���`'�;�1.'�
Sl )
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Name: �`''^�-� ��� Address• " .T_.,.��
PhoneNamber• � 12Zg(—/D�ate: � �')��'�
Signature:
Witness Si�nature:
FRIDI.EY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANlTARY SEWER.
ADMlNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191)
_ 402.05.PERMIT FEE
Prior to canstructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the apptication is made,the owner or contractor shatt be required tv 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 shaii 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 suitable connection.
402.4&. REPAIRS AND MAINTENANCE TO CONNECTiON
After the initial connection has been made to the water service curb stop box or the sewer tead 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 sha!!be liable for all repairs required to any water(ine 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 owne�shall be charged for the casts of the
maintenance andJor repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. tt shalt be the responsikaility 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 638,1156,1191j