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�.n� AUTOMATIC METER READER
FRIDLEY
Address �U�c74� `�� �j7 �..� .�-- .
Name ���'x� ��JA�`��-�fJ �'���
Date l "��~��
Old Meter Number �
Old Meter Reading L"I t� Q
ReplacementNo. ������
Replacement Reading �
Replacement Make
ERT# J�� �Q��'1
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 Frid{ey and/or its
emp{oyees 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 to the premise and alt interior plumbing. (Per City code
402.06) i aiso hold the City of fridley andiits employees harmless for any damages that may occur
while doing this operation. This to i�clude,but not limited to;valves,piping.walls,fioors or the curb
� stop box and service line. 1 understand i am also required to obtain a permit prior ta any work,if
necessary. �Q
readin old meter � �
Final meter g( 1 � �n
Name: _ Address�
+1 �-�
Pfione Number: Date: � w`�— 4
Signature:
_ Witness Signature: .
fRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMiNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144, 1156, 1191) .
;r;
,.
402A5.PERMIT fEE
Prior to constructing or repair of any water or sewer line connecting the existing municipai system and any house
or buitding for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be noti�ed. It shall be unlawful to cover any connecting iine untii an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
Affer the initial connectio�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 fine for connection,the appticant,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. If the praperty owner requests
maintenance service o�repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, inciuding any necessary street repairs,at a rate set annually by an administrattve
policy. lt shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service iine from the premises to the main including debris c{earin�ar roat cutting and to maintain the
water service cur6 stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)