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'� U�'��INSTALLATION
GN� AUTOMATIC METER READER
FRIDLEY ,
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Name �.�i 1� ��.�
Date ��—C����
Old Meter Number '` ���
O1d Meter Reading �
Replacement No. �� �� �� _
Replacement Reading �
Replacement Make '� �.
ERT# ���� � 'V
Replacement ERT#
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. ' City of Fridley
Water Deparbnent
6431 University Avenue NE
Fridley MN 55432
(763) 572-3561
Uwe 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 li.ne from the main to the premise and all interior
plwnbing. (Per City code 402.06} I also hold the City of Fridley andfor its employees
harmless for any dainages 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 also required to obtai.n a permit prior to any work,if necessary.
Name: Address: J�Q� ���T�
Phone Number: Date:��
Signature:
Witness Signature: �����w�
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FRIDLEY CTTY CODE
CHAPTER 402.WATER,STORM WATER AND SANTTARY SEWER
ADMIlVI.STRATION '
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191)
402.05. PERMIT FEE
Prior to consiructing or repair of any water or sewer li.ne connecting the exisiing municipal system and any
house or buildin.g for which the applicaiion is made,the owner or contractor 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
cannecrion has been made,the Water and Sewer Departmen.t shall be notified It shall be unlawful to cover
any connecting}ine untit an inspection has been made and such connection and the work incident thereto
has been approved by the City as a proper aud suitable connection.
' 402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water serwice 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 sha11 be liable for all repairs required to any
water line and any sewer lines necessary for connection of the premises from the main to the premises. If
the property owner requests maintenance services or repairs be performed by the City,the property owner
shall be charged for the costs of the maintenance and/or r�pairs,including any necessary slreet repairs,at a
rate set annually by an administrative policy. It shall be the responsibility of the applicant,owner,occupant
or user to perform standard maintenance of the sewer service line from t.�e premises to the main including
. debris clearing or root cutting aud to maintain the water service curb stop box for operability and at such
height as will ens�e that it remains above the finished grade ofthe land or property. (Ref 638, 1156, 1191)