Meter Swap '� U�-v'� �-�3�-Y�sa-3J
� INSTALLATION
�.N� AUTOMATIC METER READER
FRIDLEY
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Address ! r- ����
Name �f�,MAr� �C:�-4Af-�-
�ate � '� - l�,
Old Meter Number � o�.
Old Meter Reading cJ �
Replacement No. �� o�� o��
Replacement Reading C�
Replacement Make ����.
ERT# ��7�0����
Replacement ERT# �.�
Remarks: �
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City of Fridiey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��wE hereby authorize the City of Fridley and/o�its
employees to do what is necessary t�replace the water meter. I understand that the property owner
is iiabie for the water line from the main to the premise and ali interior piumbing. (Per City code
402.06) i alw hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,wa{Is,floors or the curb
stop box and service line. 1 understand i am also required to obtain a permit prior to any work,if
necessary. ���
Flnal meter reading{oid meter) �
Name• Address:_ �`�J �v��
Phone Number• Date: '"�—��
Signature• � �'' �
. INitness Signature: .
FRIOLEY CtTY CODE � "�
CHAPTER 402.WATER,S70RM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566;629,638,662,922,988, 1144, 1156,1191)
402A5. PERM17 FEE
Prior to constructing or repair of any water or sewer line conneeting the existing municipal system and any house
or building for which the appiication is made,the owner or contractor shail be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shail be notified. It shall be unlawfui to cover any connecting tine until an
inspection has heen made and such connection and the work incident thereto has been approved by the Cty as a
proper and suitable connection.
402.06.REPAIRS AND MA{NTENANCE TO CONNECTiON
After the initial connectian has been made to the water service curb stop box or the sewer lead at the p�operty
line or a water service or sewer{ead has been extended to the property line for connection,the applicant,awner,
or the occupant or user of such premises shatl be liabfe for atf repairs required to any water{ine and sewer lines
necessary for connection of the premises from the main to the premises. tf the property owner requests
maintenance service o�repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an admtnistrative
policy. it shalt be the responsibi{ity af the applicant,owner,occupant or user to perform standard maintenance of
the sewer service{ine from the premises to the main incfuding debris c{earing or root cutting and to maintain the
water service curb stop box for operability and at such height as wifl ensure that it remains above the finished
grade of the fand or property. (Ref 638,1156,1191)