Meter Swap t��3�-��r�«
'� f/'�'�� INSTALLATION
UlYOF AUTOMATIC METER READER
FRIDLEY ��,��
Address � (�I`���.% �
Name� V�tJ ic�Z��
Date ��- � " ��
Old Meter Number � � �
OId Meter Reading U ��
Replacement No. 5
Replacement Reading � _
Replacement Make �
ERT# �� �
ReplacementERT# i'
Remarks:
c��-�- Signed:
4
� f�+�quE:�t fc�r�err� Ft
Gi�y�f Frid�
F� 3�; �1-12 �e: �"12l�712
T�e� in�a��4MR n�eF fr� �: '
�1+�p�: V1dat,e� f�Fize�t�. �Pe�rs
f�d�: 6�D�TH 5T� . �7�-�
�: 3fl61�Z�72�1�D iAM �I'"�(��- ,. t?�t�rer: ' E+e�rs
_ �[Ir�a�: i�w�t
Ai�Tai��
�
'��= ��05��
���� �35� �`�59
�� �
���� 3`3�8 �ca56
�
�
�
� �
�
�
�
�
�
' �
�
�
�
� � �
E
�_�__.�_._ _ �___� ___________�____.___..___________�____.____.___
f �
���� �
� ;
� ___e_.__ �_ _____ _ _ � ._.____w_�.______.__�
�= _: �__._� __ ��
€ �-� �C� I � �
,
�
- City of Fridiey
Water Department
6431 Universiiy Avenue NE
Fridley,MN 55432
(763)572-3556
I/we hereby authorize the City af Fridiey and/or its
emplayees to do what is necessary to repiace the water meter. 1 understand that the property owner
is tiabie for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) 1 also hold the City of Fridiey and/its employees harmless for any dartages that may occur
while doing this operation. This to include,but not{imited to;va{ves,piping,wa{Is,fioors or the curb
� stop box and service tine. i understand 1 am also required to abtain a permit prior to any work,if
necessary.
Pinal meter reading�otd meter) ' � ��
Name• Address•, ��/�(/w` �Z� [�_
Phone Number: Date: �"'(�J � `�_
Signature•
Witness Signatur .
FRIDLEY CITY C�DE
CHAPTER 4QZ.WATER,STORM WATER,AND SANITAR1l SEWER
ADM1NfS'i'RA710N
(Refi Ord No 113,464,565,566,629, 638,662,922,988, 1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repalr of any water or sewer line connecting the existing municipal system and anjr house
or building for which the application is made,the owner or co�tractor shall be requi�ed to obtain a permit for such
connection,and shal{pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
snade,the Water and Sewer Department shaft be notified. It shail be uniawful to cover any connecting line untii 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.
d02.06. REPAIRS AND MAINTENANCE TO CONNECTiON
After the initial connection has been made to the water senrice curb stop box ar the sewer lead at the property
line or a water service or sewer lead has been extended to the property{ine for connection,the applicant,owner,
or the occupant or user of such premises shall be liabte for ali�epairs required to any water line and sewer lines
necessary for cnnnection of the prernises from the main to the premises. If the prope►ty awner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. tt shal4 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 clearing or root cutting and to maintain the
water service curh stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j