Meter Swap '� �f�l ,-�-- ;�-.�r;��-S'—`f G��'�'7�
� � `� INSTALLATION
crnroF AUTOMATIC METER READER
FRIDLEY
Address ��� � ����
Name 1`'`�c�C��l�`� �lTl'�
Date �"��" � �
OId Meter Number L � �
Old Meter Reading �CJ� ��
Replacement No. �� �� b�
Replacement Reading �
Replacement Make � � �
ERT# ��� ( �� �
Replacement ERT#
Remarks:
.�� 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 andior 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 all interior piumbing. (Per City code
402.06) 1 alsa hoid the City of Fridtey and/its employees harmless for any damages that may occur
while doing this operation. This to inctude,but not limited to;vaives,piping,wa{Is,floors or the curb
� stop box and service line. t understand{am a{so required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter)' �J� I � 4�
Name• Address• �,,��_,�,�,,)���
Phone Number: Date: L� — ��� l t�___
Signaturec ��v ' ��"�
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER'402.WATER,STORM WAT�R,AND SANITARY SEWER
ADMINiSTRATION
(Ref Ord No 113,464,565,Sfi6,624,638,662,922,988,1144,1156,1191)
402.05. PERMIT FEE �
Prior to constructing or repair of any water or sewer line connecting the existing municipal 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 shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Departrnent sha11 be notified. It shafl be unlawfut to cover any connecting iine untif an
inspection has been made and such connection and the work incident thereto has 6een approved by the City as a
proper and suitable connection.
402.Ofi. REPAIRS AND MAINTENANCE TO CaNNECTION
After the initial connection has be�en 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 ta the property line for connection,the applicant,owner,
or the occupant or user of such premises shatt 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 pertormed by the City,the property owner shall be charged for the costs of the
maintenance a�d/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall 6e the�esponsibility of the applicant,owner,occupant pr user to perform standard maintenance of
the sewer service line from the pr�mises 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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)