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�� AUTOMATIC METER READER
FRIDLEY
Address ���1 � � ��
Name ���"ti.� ����°irt,-�
Date �{����'��
Old Meter Number � � �
Old Meter Reading �� �
Replacement Na �� I � � 1
Replacement Reading��
Replacement Make , '�� ,
ERT# � �)` { V��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
emptoyees to do what is necessary to replace the water meter. i understand that the property owner
is liable for the water line from the main ta the premise and all is►terior plumbing. (Per Gfiy 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;vaives,piping,walls,floors or the curb
stop box and service line. I understand I am aiso required to obtain a permit prior to any work,if
necessary. �,� A
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Final meter reading(old meter) �-��v
Name• Address: �.� ���� �Z—
Phone Number: Date: 1�—� ���
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Signature•_ I Y ` �, ���
Witness Signature:
FRIDLEY CITY CODE
CHAP7ER 402.WA1'ER,STORM WATER,AND SAN{TARY 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 sewe�line connecting the existing municipal system and any hou5e
or building for which the application is made,the owner or contractor shail 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 shatt be notified. It shall be unlawful to caver 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 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 tothe property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for aif repairs required to any water fine and sewer lines
necessary for connection of the premises from the ma+n ta the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be char�ed for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. it shali be the�esponsibility of the appticant,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(and or property. (Ref 638,1156,1191)