Meter Swap � �� � � INS LLA ION�>��
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unroF AUTOMATIC METER READER
FRIDLEY
Address � f� � � 6�� -� �
Name ljc» C'c�l �+'1� J y �' �S c��j
Date � - � � ��
Old Meter Number � �� �
Old Meter Reading 1 � 7 ��
Replacement No. l"� 3 d 3� � �.� _
Replacement Reading �
Replacement Make � 9.N.
ERT# 333 � Q `� f �
Replacement ERT#
Remarks
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Signed: ' 6
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
t/we hereby autfiorize the City of Fridiey andjor its
empluyees to do what is necessary to replace the water meter. I understand that the property owner
is liabte for the water line from the main ta the premise and ail interior plumbing. (Per City code
402.06) i alsa hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walis,floors ar the curb
� stop box and service iine. I understand i am aiso required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter} �� [ � � ��
Name: '� , -- . . _ . --�-Address: � °��� � �� ��
Phone Number: � Date: � J � `sr /`'�
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Sign ' ; /.,�o,`.
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. Witn�ss 5ignature: � '
FRIDLEY CiTY COQE
CHAPTER+402.WATER,STORM WATER,AND SANITARY SEWER
���� � � ADMINISTRATION
� (Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191)
402.Q5. PERMIT FEE
,� Prior to constructing or repair of any water or sewer li�e connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shali 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 sha�l be notified. It sha!{be unlawfu{to cover any connecting line untit 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.
A02.06. REPAIRS ANO MAINTENANCE 70 CONNECTION
After the initial connection fias 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 applicant,owner,
or the occupant or user of such premises shali 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. {f the property owner requests
maintenance service or repairs be pe�formed by the City,the property owner shall be charged for the costs of the
maintenance andjor repairs, including any necessary st�eet repairs,at a rate set annually by an aciministrative
policy. It shall be the responsibility of the applicant,awner,occupant or user ta 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 wiH ensure that it remains above the finished
grade of the land or property. (Ref 538,1156,1191)