Meter Swap � G���� I STALLATION���
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v.noF AUTOMATIC METER READER
FRIDLEY ����
Address ' ��� 5 (
Name �%�`�y 1`���1������:
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Date � ��- ��
Old Meter Number � � lt�
Old Meter Reading � DQ
Replacement No. �
Replacement Reading �
Replacement Make �K-,
ERT# ���� ��}"t�C1
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 Uniyersity Avenue NE
Fridley,MN 55432
(763)572-3566
1/we hereby authorize the City of Fridiey andJor its
empioyees 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 ta the premise and all interior piumbing. (Per City code
402.06) t aiso hoid the City of F�idley and/its employees harmless for any damages that may occur
while doing this operatian. This to inctude,but not limited to;valves,piping,wa{Is,floors or the curb
� stop box and service line. 1 understand{am afso required to ebtain a permit prior to any work,if
necessary.
Finaf ineter reading(old meter) �� �.
Name: Address• f0����_����
Phane Number: Date: `" `
Signature•
Witness Signatur
FRIDLEY CfTY C�DE
CHAPTER 4U2.WATER,STORM WATER,AND SANITARY SEWER
ADMIN{STRATf�N
(Ref Ord No 113,464,565,566,6�9,638,662,922,988,1144,1156, 1191j
402.05. PERMiT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq hause
or building fo�which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shail pay a permit fee as provided in Chapter 11 of this Code, After such connection has been
made,the Water and Sewer Department shait be notified. lt shall be unlawfu!to caver any connecting(ine 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 TO CONRI�CTiON
After the initial connection has been made to the water service curb stop box or the sewer lead at the property ,;,
line ar a water service or sewer lead has been extended to the property line for connection,the app{icant,awner, '
or the occupant or user of such premises shati be liabie for all repairs required ta any water{ine and sewer lines
necessary for connection Qf 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 shali be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annualfy by an administrative
poticy, It shall be the responsibility af the applicant,owner,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 operabifity and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)