Meter Swap � -��;�, _��-��w
�� L' �z� INSTALLATION
G.�� AUTOMATIC METER READER
FRIDLEY
Address �.�?�� � t)1/�. �3�
Name ���-f�.. �4L 5��.�
Date �'-1�" 1�
Old Meter Number , �U`����
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Old Meter Readin cc��
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Replacement No. `t�Tv,., ��n�'1 F.�i�
Replacement Reading �
Replacement Make ��t�JC�
ERT# (>f � ���
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Replacement ERT#
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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
employees to do what is necessary to replace the water meter. I understand that the properly owner
is liabie for the water line from the main to the premise and ail interior plumbing. (Per City cade
40�.06) i also hold the City of Fridiey and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;vaives,piping,wafis,floors or the curb
� stop box and service line. i understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter)
Name: Address:_���� � ��tl��
Phone Number: Date: �- C����
Signature:
. Witness 5ignature: �-�lJ�P-"�
�—
FRIDLEY CITY CODE
CHAPTER 40Z.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,5b6,629,638,662,922,988,1144, 1156, 1191)
402.05. RERMIT FEE
Prior to constructing or repair of any water or sewer�ine connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shatl pay a permit fee as provided in Chapter 11 of this Code. After such conneetion has been
made,the Water and Sewer Department shall be notified. It shail be unlawful to cover any connecting line until an
inspection has been made and such connection and the wvrk incident thereto has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initiat 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 connection,the appiicant,owner,
or the occupanC or user of such premises shall be liable for ail�epairs required to any water line and sewer lines
necessary for conr►ection of the prernfses from the main to the premises. lf the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shail be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer se�vice line from the premises to the main including debris clearing ar root cutting and to maintain the
water service curb stop box for operabifity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191) •