Meter Swap � �� r� 1 (�'!��S�t(�3�v
'� � INSTALLATION
��.��. AUTOMATIC METER READER
FRIDLEY
Address ��� � �C��� `i�
Name �'�iJ� �ps�:���i-�
Date � _��Z(�,
Old Meter Number �
OId Meter Reading l �,
Replacement No. L� 'r..�' Q •�1
Replacement Reading (�
Replacement Make �
ERT# �3� (
Replacement ERT#
Remarks: ��
3� � Signed: ����
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City of Fridley
Water Department
6431 University Avenue NE
Fridiey,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
emplayees to do what is necessary to rep�ace the water meter. I understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
402.06) i also hold the City of Fridley and/its employees harmiess for any damages tfiat may occur
whi{e doing this operation. This to include,but not 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.
Final meter reading(old meter) � �
Name• Address�_��� �� �-F1"`
Phone Number: Date: ,� ^�R'�
Signature: '�
_ Witness Signature: "^'y"�'^'-� .
FRtDLEY CtTY CODE
CHAPTER 402.WATER,S70RM WATER,AND SANiTARY SEWER
ADMiNiSTRATiON
(Ref Ord No 113,464,565,556,629,638,662,922,988,1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipat system and any house
or building for which the application is made,the owner or contractor shall 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 sha11 be notified. It shaN be un{awfui to cover any connecting line until 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 sewer tead 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 shall 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. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the cosis of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance ofi
the sewer service iine from the premises to the main including debris c{earing ar root cutting and to maintain the
water service cur6 stop hox for operability and at such height as will ensure that it remains above the finished
grade of the iand or property. (Ref 638,1156,1191�