Meter Swap � ��"�� INSTA T ON����
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G.n� AUTOMATIC METER READER
FRIDLEY
Address �c.�� ������
Name ��� �C���p�
Date � � `��'��
Old Meter Number J' �
Old Meter Reading ��
Replacement No. `-1 �J�OZ� ��
Replacement Reading 4�
Replacement Make �� �
ERT# ������.��
Replacement ERT#
Remarks:
)J�71 Signed:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridiey and/or its
emp{oyees to do what is necessary ta replace the water meter. i understand tfiat the property owner
is liable for the water line from the main to the premise and ali interior plumbing. (Per City code
402.06) I also hold the City of Fridiey and/its employees harmless for any damages that may occur
while doing this operation. This to include,but nat limited to;valves,piping,walls,floors or the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary. � �
Fina{meter readina(�{�meter) �
Name• Address•_ �Vl.) '—' cJ� ��,��
Phone Number. Date: � \�l
Signature•��� �:,Q.�z_. -
Witness Signature: �S\�
FRIDLEY CITY CODE
CHAPTER 4Q2.WA7ER,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 any house
or building for which the apptication is made,the owner or contrador shalt be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapte�11 of this Code. After such connection has been
made,the Water and Sewer Department shali be notified. ft shaH be uniawfuf to cover any connecting iine untit 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 stap box or the sewer lead at the property
line or 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 shal{be{iab{e for alf repairs required to any water line and sewer{ines
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 City,the property owne�shall be charged for the costs of the
maintenance andlar repairs, including any necessary street repairs,at a rate set annually by an administrative
poficy. It shall be the responsibifity of the appticant,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 senrice cur6 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)