Meter Swap '� I�,���-��a���
� �'��INSTALLATION
G.N�. AUTOMATIC METER READER
FRIDLEY
Address�\� '�" �?� � i
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Name �`��; � �-�
Date ��—��� (�
Old Meter Number �
Old Meter Reading �S� �
Replacement Na ��� �4(
Replacement Reading C�
Replacement Make ��
ERT# ��,�,l���O�
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763}572-3566
f/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 property owner
is liable for the water line from the main to the premise and ali interior plumbing. (Per City tode
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but aot limited to;valves,piping,walis,floors or the curb
' stop box and service line. I understand i arn also required to obtain a permit prio�to any work,if
necessary.
Final meter reading(old meterj ��� �� �,��
Name� Address• `�� (JV" �?`�S�
Phone Number: Date: �'"1�'� ,
Signature: � ��'�'��
Witness Signature:
FRiDLEY CITY GDDE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipai system and anq house
or buitding for which the appiication is made,the owner or contractor shaH 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 connection has been
made,the Water and Sewer Department shali be notified. It shall be unlawful 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.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewe�lead at the property
line or a water senrice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall he liable for ail repairs reguired to any water tine and sewer lines
necessary for cannection of the premises from the main to the premises. if the psoperty owner requests
mainte�ance service or repairs be performed by the City,the property owner shal{be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a tate set annually by an administrative
policy. It shal{be the responsibifity of the applicant,owner,occupant or user to perform standard maintenance of
° the sewer service line from the premises to the main inciuding debris ciearing or root cutting and to maintain the
water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)