Meter Swap / �71 �� ( �FY/„1�+iJ
'� �'��� INSTALLATION
U.N� AUTOMATIC METER READER
FRIDLEY
Address L�"�l.,J �- � t� �`
Name � '���L ���
Date -
e -
Old Meter Number ( r t '
Old Meter Reading �
Replacement No. r
Replacement Reading �
Replacement Make �F�uJ�-�'�--
ERT#������ 1 ✓
Replacement ERT#
Remarks:
s-�-�,} Sianed:
, F����ftu�rvit�: R�►r�
• Cit�yy t�f Fr�d�/
i� �a: �1-12- ��: sd2�12
T�e� AMR�f+er E�y�
�e�t: 11iRFFa�er ��: �+i'�+�rrt
Aidd�: 1 �TH h'�'E NE . 7�71-2�
Sc�eckied Q�te: 5�121�t'!�1 ' t}�nec�
t��: Fieiquea� [Ir�tai�s: Ai�t.
� _
+�ld �'let�er# � ��j S ��� t
�
�!t'�Icl re�cling: ���`��' j�
�ev�v �e�r # �7j(� t�j'�(0
�
�Ve�r Reading: �
�
���� ��� a���
�
�
�
�____� _ __�_ � �____���______�____��_ ____
� ��� � ; � � �
�
� ,
� __ _ __��� _ _�____ _ �� �__�___�_��_____
� �: � �
�
� .�_ � ��-�� �.�_. .
I
• City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-356fi
I/we hereby authorize the City of Fridley and/ar its
emplayees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line fram the main ta the premi5e and all interior plumbing. (Per City code
402.06) 1 alsa 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,wal(s,floors or the curb
� stop box and service lir+e. !anderstand I am also required to obtain a permit prior to any work,if
necessary. ��� � �, �
W
Final meter reading(old meter)
Address: N Jl�v r"'_, •��"�
Name: .
Phone Number: Date: � �`��
Signature:
_ Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANRARY SEWER
ADMINISTRATIQN
(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 municipat system and any house
or 6uilding for which the application is made,the owner or contractor shall 6e 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 Department shall be notified. It shall be unlawful 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.
4�2.06. REPAIRS AND MAINTENANCE TO CONNECTICIN
After the initial connection has been made to the water service curb stop�ox or the sewer lead at the praperty
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 1ia61e for all repairs required to any water(ine and sewer lines
necessary far cannection of the premises from the main to the premises. lf the praperty owner requests
maintenance service or repairs be perFormed by the City,the property owner shafl he charged far the costs of the
maintenance and/or repairs, including any necessary street repairs;at a rate set annually by an administcative
poticy. It shall be the responsibility of the applicant,vwner,occupant ar 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 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�