Meter Swap ' �`
��'S�-('-jS'-Y?�s`-ru
J��"y INSTALLATION
c�.n,oF AUTOMATIC METER READER
FRIDLEY
Address���� �'��� ��-
Name ��� �1 �1��`(,►�
Date �����"��,
Old Meter Number � ����
Old Meter Reading �
Replacement No. ��� �� J�`�
Replacement Reading �
Replacement Make f��lJ��`°`-.
ERT# �����1�-t�
Repiacement ERT#
Remarks:
Siqned: '��
���� —�— �
' ' €��q���# fi+a�t�'.;�r�c�: R
�ity caf Fndle�
6� �: 6�i�-11 e: 12/12,�2��1
�T�e= i���#IIR� ��€�:
��: WYat+�r ��: ��
Ad�: 6�1 H PL t� � 7C3-�27-�t0
D�e= l�"ltl6�f2�f77'�J�M ` _
l��€a�: i�eque��� k�1�IFt
P+e�n�aF�en_
������ � �
�
� �-�� -- ��Q�c��f�,
o�'��ti�- ��� ��
u� r��-�— y,35�at�t
�-,� �;��- �
�,z� - ��oa a6�g
� �_.�_�____ __ � �____._ _____. _.�____� _�._��_ ���. �� �
��: ;
� � � � � � �
�
��_� _�___ . ____.._______.__,��____.
��� ��
�:
� �_ ������mm- ►.�_ _ �� �
City of Fridley
Water Depariment
6431 University Avenue NE
Fridiey,MN 55432
(763)572-3566
�/We hereby authorize the City of Fridtey and/o�its
`� employees to do what is necessary to repface the water meter. i understand that the property owner
is liable for the water line from the main to the premise and all irrterior plumbing. (Per City code
402.06) I also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but not fimited to;valves,piping,waNs,flaors or the curb
stap box and service line. I understand i am also required to obtain a permit prior to any work,if
necessary.
final meter reading(old meter) ����� �
Name• Address: E71�1 t�F L � ��-
��- �b `�t�
Phone Number: Date: -
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER.
ADMINI5TRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191)
A02.05. PERMIT FEE
Prior to constructing or repair of any wate�vr sewer line connecting the existing municipat system and any house
or building for which the application is made,the owner or contractor shali be required to abtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such cannection 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 suitable connection.
402.06. REPAIRS AND MAINTENANCE 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 co�nection,the applicant,owner,
or the occupant or user of such psemises shaN be liable for atl repairs required to any water line and seuver 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 fior 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 ar user to perForm standard maintenance of
• the sewer service line from the premises to the main inctuding debris clearing or root cutting and to maintain the
water service curb stap box for operability and at such height as wi{t ensure that it remains above the finished
grade of the tand or property. (Ref 638,1156,1191)