Meter Swap '� `'"♦ ��-� �' :�-c�-�l 1�"—����/�1�=
INSTALLATION
G7YOF AUTOMATIC METER READER
FRIDLEY
Address �1��� �� ��
Name �,,,� �l�*s'I�►E�,
Date �` � �`���
Old Meter Number Y� O�
Oid Meter Reading �� d���
Replacement No. � �� L
Replacement Reading � ___
Replacement Make �FTZJ�.x`� �
ERT# ���� C�� D� , ,/
Replacement ERT#
Remarks
��..� Signed:
, E2�q��s# f�rr�r�ri+� R�P�r#
, �ity c�f ��d�
� ('�o: �1-1z-4�s? �t�: s.�t2t2+�12
�T�re: k�t�r�i��eter E#y. �
[�ep�t: I�tater �Fia�: �Stanetc
Ad�: �1 lIBL:E ST WE ' _ 763�7't-3�54
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E.�r�De€a�s: Ei�r�e��: l�i.
Ta�e�
+�Ic� M�t+�r # �� C�� �J(p��,
�Id r�dir��: �1��p� 4��
�I+�w �Ae�r# �{��'p 1�1-1 S
�lew �eading: �
E�T# �J�3� �� g�
,
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�__ _ ___________ .�... _._. __...__._�__
_ �
�__ ________.___._....�__�__._
c��: r ( u_I� �
,�_. -t
City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabte for the water fine from the main ta the premise and all interior plumbing. (Pes City code
402.06) I also 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;�alves,piping�walis,floars or the curb
� stop box and service line. i understand I am also requlred tv obtain a permit priar ta any work,if
necessary.
Final meter reading(old meter) �� �
Name�
Address: v�` ���
Phone Number: �a ' ��� '
Signature:
. Witness Signature:
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMIINISTRATION
(Ref Ord No 113,464,565,566,6�9,638,662,922,488,1144,1156,1191)
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 Department shali be notified. It shall be unlawful to cover any connecting line untii 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.
4U2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service carb stop box or the sewer lead at the property
line or a water setvice or sewer lead has been extended ta the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all�epairs required to any water line and sewer(ines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs 6e performed by the City,the property owner shall be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or 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 operabifity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j