Meter Swap � �`���� IN�TALLATION���)r��v
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v.noF AUTOMATIC METER READER
FRIDLEY
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Name ��i��t- �t 1,.5
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Date ""`
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Old Meter Number 3 �
Old Meter Reading �7 l�
Replacement Na �
Replacement Reading QS
Replacement Make �J�'����—.
ERT# �� �V�� Q�
Replacement ERT#
Remarks:
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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 Fridtey and/ar its
employees to do what is necessary to replace the water meter. I understand that the properly owner
is liab(e for the water iine fram the main to the premise and ali interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,hut not(imited to;valves,piping,walls,floars o�the curb
stap box and service line. I understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter) ��`�� � ��
Address• �____ �/��~ �� ��� -
Name• .
Phone Number: Dafie:___ ��—�� •
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Signature:
. Witness Sig ure:
FRtDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565r 566,6�9, 638,662,922,988,1144,1156,1191)
40Z.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building far which the application is made,the owner or contractor shali 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 Department shall be notified. It shall be unlawful to tover any connecting line until an
inspection has 6een made and such connection and the work intident thereto has been approved by the City as a
proper and suitable connection.
4U2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been 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 to the property line for connection,the applicant,owner,
or the accupant or user of such premises shall 6e liable for all repairs required to any water line and sewer lines
necessary far connection of the premises from the main to the premises. lf 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/ar repairs, inctuding any necessary street repairs,at a raCe set annualty by an administrative
po(icy. It shall be the responsibility of the applicant,owner,accupant ar user to perform standard maintenance of
the sewer service tine from the premises to the main including debris clearing or root cutting and to maintain the
water se�vice 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)