Meter Swap '_ ' :. � �-((�?�%7 S^—�t(�(r�.�-l c�
� '�--'��� INSTALLATION
G.n�. AUTOMATIC METER READER
F�ua.�r -
Address ��� "'" �-t?��NC:
Name ���� PtfLLe"'aC�
Date ����� ,
Old Meter Number ' �
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Old Meter Reading
Replacement No. �
Replacement Reading � t
Replacement Make � ��
ERT# ��� t�b�� �
Replacement ERT#
Remarks:
5 a-a� Signed:
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� - City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-356fi
��We hereby authorize the City of Fridley and/or its
employees to do what is necessary to repiace the water meter. I understand that the property owner
is liabie for the water iine firom the main to the premise and all interior ptumbing. (Pec City code
402.06) 1 also hold the City of Fridtey and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,watls,floars or the curb
� stop box and service line. 1 understand I am also required ta obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) � � �� ���
Name: Address:_��� ����
Phone Number: Date: v��-L`� �� — �
Signature:
_ Witness Si ature:
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER.AND SANtTARY SEWER
ADIIAINISTRQTION
(Ret Ord No 113,464f 565,566,629,638,662,922,488,1144, 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�epartment shall be notified. It shall be unlawful to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
4U2.06. REPAIRS AND MAINTENANCE TO CQNNECTIdN
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 fead 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 af 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 costs of the
maintenance and/ur repairs, including any necessary street repairs,at a rate set annualty by an administrative
policy. It shall be the responsibility of the appticant,owner,occupant ar user to perform standard maintenance of
the sewer service line from the premises to the main including debris clearing o�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)