Meter Swap ���� �� �����J
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�.�� AUTOMATIC METER READER
Fwn�.�r ,
Address f���j F�J� ��
Name �,e�� � �A'�
Date V'� - �p�
Old Meter Number � � �
_ Old Meter Reading �
Replacement Na �� �
Replacement Reading � _
Replacement Make ���%��
ERT# G���� �0��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby autharize the City of Fridley and/or its
employees to do what is necessary Co reptace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per 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;vafves,piping,wafls,fioors or the curb
� stop box and service line. i understand I am alsa required to obtain a permit prior to any work,if
necessary. A
final meter reading�old meter)______�� ���C�'��
� ��� �L.-� `�T
Name• Address: -
Phone Number: Date: � � 1�
Signature: �
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADM{NISTRATtON
(Ref Ord No 113,464r 565,566,629,638,662,922,988,1144,1156,1191)
402.05. PERMIT FEE
Prior tfl constructing or cepair 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 shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department sha{!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.
40Z.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop 6ox or the sewer iead 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 occupant or user of such premises shall 6e liable far all�epairs required to any water line and sewer lines
necessary for connection of 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/or repairs, inc{uding any necessary street repairs,at a raCe set annuaily 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 or root cutting and to maintain the
water service curb stop box for operability and at such height as wilf ensure that it remains above the finished
grade of the land or property. (Ref 638,1156, 1191) .