Meter Swap '= �,-��,� :�-���'—`�4�����
INSTALLATION
u.nroF AUTOMATIC METER READER
Fwa�r .�
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Address "-y
Name �t��� �cRL��'�'�`
Date ��" ����
Old Meter Number � � `
Old Meter Reading � �� _ - �
Replacement No. � � 1 ��� 1
Replacement Reading��
Replacement Make���7�°�
ERT# J��y u}�Ia `�
Replacement ERT#
Remarks:
)�(� Signed:�,_ �
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City of Fridley
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 replace the water meter. I understand that the property owner
is liable for the water line from tfie main to the premise and all interior plumbing. (Per City code
402.06) 1 also hold the City of FMdiey and/its empioyees harmiess for any damages that may occur
while doing this operation. This to include,but not limited to;vaives,piping,walls,floors or the curb
stop box and service line. I understand t am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) � �� 6�
�Q��
Name• Address• �,��/ 4 �
Phone humber. Date: �'l
Signature•
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Witness Signature:
FRIDLEY CiTY CODE
CHAPTER 402.WATER,STQRM WATER,AND SANITARY SEWER.
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 114A�, 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 appticat9on is made,the owner or cantractor shall 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 shaif be notified. lt shail be untawfui to cover any connecting Vine until an
inspection has been made and such connection and the work incident thereto has been approved by the�ty as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTtON
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 shall be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. lf ttve 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 annual{y by an administrative
policy. it shall be the responsibility of the appiicant,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 bax 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�