Meter Swap '� �� �a-�'i�c�S'-`ft�,a�y cv
� v INSTALLATION
u.NOF AUTOMATIC METER READER
F�a�
Address �'J��� �� �i�� ��
Name �� m�Ci��
Date �-- I[�` �'d�
Old Meter Number i ��5�
Old Meter Reading �
Replacement No: "1�`�J 1 cl�� l a�
Replacement Reading �
Replacement Make
ERT# � a
Replacement ERT#
Remarks:
�j�" Signed:
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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 ta do what is necessary to replace the water meter. I understand that tfie property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
40Z.06) f also hold the City of Fridiey and/its employees ha�mless for any damages that may occur
while doing this operation. This to include,but nat timited to;valves,piping,walls,floors or the curb
stop box and service line. i understand i am afso required to obtain a permit prior to any work,if
necessary.
Finaf ineter reading(old meterj �� � ��
Name� Address• ��� ��� �7
Phone Num Date: !��`��� .
Signature: � `�
Witness Signature:
FRI04EY CITY CODE
CHAPTER 402.WATER,STt?RM WATER,AND SANITARY SEWER
ADMINtSTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
y:R
402.05. PERM{T FEE
Prior to constructing or repai�of any water or sewer line connecting the existing municipal system and any fiouse
or building for which the application is made,the owner or contractor shaU be required io obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Wate�and Sewer Department shal{be noti�ed. It shall be unfawful to cover any connecting iine until an
inspection has been made and such connectian and the work incident thereto has been approved by the�ty as a
proper and suitable connection.
402.06. REPA{RS AND MAfNTENANCE TO CONNECTION
After the initial coRnection 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 ifne for connection,the applicant,owner,
or the occupant or user of such premises shalf be liabte for all repairs required to any water line and sewe�lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the Ciiy,ihe property owner shall be charged far the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annuatly by an administrative
policy. It shatl be the responsibitity of the applicant,owner,occupant or user to perform stas+dard 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 wi{I ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)