Meter Swap �3�������
�� (i�-�'� INSTALLATION
u-nroF AUTOMATIC METER READER
FRIDLEY
Address �� �✓ ' �%����tv`t
Name ���1�:: �A�L
Date ���'��—� d�
Old Meter Number ( ��� ��
Old Meter Reading � � r
Replacement No. ���� � �
Replacement Reading Q�
Replacement Make _ �
ERT# .�7? -`J��S�
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
)Jwe hereby authorixe the City of Fridtey and/or its
empioyees to do what is necessary to replace the water meter. l understand that the property owner
is liable for the water line frorr�the main to the premise and all interior plumbing. (Per City code
402.06) ,t also hold the City of Fridiey and/its employees harmiess for any damages that may occur
,. .,. while doing this operation. This to include,but not limited to;valves,piping,walis,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�oid meter)
J
Address• � �'' � ��`-1 --
Name: —
Phone Num Date: l VF����
Signature•
Witness Signature:
FRIDLEY CITY CODE
CHAP7ER 402.WATER,STORM WATER,AND SANITARY SEWER �,;�, �;�
ADMINISTRA7I�N `;�
(Ref Ord No 113,4fi4,565,566,629,638,662,922,988, 1144,1155,1191) '
402.d5.PERMIT fEE
Prior to constructing or repair of any water or sewer line conneding the existing municipal system and any house
or building for which the application is made,the owner or contractor shail be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter il of this Code. After such connection has been
made,the Water and Sewer Department shali be notified. It shaii be unfawful to cover any connecting line until an
inspection has been made and such conr►ection and the work incident thereto has 6een 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 cu�b stop box or the sewer lead at the property
fine or a water service or sewer iead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shali be liable for all repairs required to any water line and sewer lines
necessary for connection of the premises frorn the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shal{be charged for the costs of the
maintenance and/or repairs, including any�ecessary street repairs,at a rate set annuatly by an administrative
policy: It shall be the responsibiiity of the applicant,owner,occupant or user to perform star+dard maintenance of
� the sewer service line from the premises to the main including debris clearingor root cutting and to maintain the
water service curb stop box for operability and at such hei�ht as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)