Meter Swap � �� �" � i STALLATION �
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�n�. AUTOMATIC METER READER
FRIDLEY �
Address �7J � �� S
Name �Q� �� h �, r. �
Date ���� ' � �
Old Meter Number / � 0�b 7`"�
Old Meter Reading �� j��
Replacement No. �3 J ��-�.�3
Replacement Reading �
Replacement Make /,��-��z�..�-
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
� �� Ci of Fridie and or its
I/we hereby auth�rize the ty y /
empioyees to do what is necessary to repiace the water meter. 1 understand that the property owner �
is liable for the water line from the main to the premise and ali interior pfumbing. (Per City code
40Z.06) 1 aiso hold the City of Fridley andiits emptoyees harmless for any damages that may occur
white doing this operation. This to include,but nat limited to;vaives,piping,walfs,floors or the curb
� st�p bax and service line. I understand 1 am aiso required to obtain a permit prior to any work,if
necessary.
Final mete eading(oid meter) � ` � �✓� �
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Name: A'��������Address: ��s19 �
Phone Number: `�1�'�`�Z ��� ate: 7�� "- ����
Signature: ��v�v'"�
. Witness Signature: �� /./-�-5—�--�
FRiDLEY CiTY CODE
CHAP7ER 402.WATER,Sl'ORM WATER,AND SANITARY SEWER
ADMfNfSTRATiON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144, 1156, 1191j
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 application is made,the owner or contracior shaif be required�o obtain a permit for such
connection,and shal{pay a permit fee as provided in Cfiapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting iine 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 70 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 ta the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be tiabie for all repairs required to any water line and sewer lines
necessary far 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 shalf be charged for the costs of the
maintenance a�d/or repairs, including any necessary street repairs,at a rate set annuaily by an administrative
policy. It shall be the�esponsibility of the applicant,awner,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 wil!ensure that it remai�s above the finished
grade of the land or property. (Ref 638,1156,1191)