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INSTALLATION
G7YOF AUTOMATIC METER READER
F'RIDLEY
Address tl��� 1 �tr�� �(
Name , C��L`{ ��U Pr��
Date �—��
Old Meter Number 1 l�
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Replacement No. �
Replacement Reading �
Replacement Make � i 2
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
i/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to repiace the wate�meter. I understand that the property owner
is liable for the water line fram the main to the premise and all interior plumbing. (Per City code
402.06� 1 also.huld the City of Fridley andJits employees harmless far any damages that may occur
while doing this operation. This to include,but not(imited to;valves,piping,walls,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 readin old meter) ���� ���
g�
Name: Address:_ � �\C��?
Phone Number: ' Date: � L 1 `1� •
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Signature:
. Witness Signatu e:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATIQN
(Ref Ord Na 113,464,565,566,629, 638, 662,922,988.1144,1156,1191j �
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or buildi�g for which the appiication is made,the owner or contractor shall be required to obcain a permit for such
connection,and shail pay a permit fee as provided in Chapter il 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 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 connectian.
4a2.06. 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 prope�ty
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 liable for all�epairs required to any water fine and sewer lines
necessary for conne�tion of the premises from the main to the p�emises. If the property owner requests
maintenance service or repairs he perFormed by the City,the property owner shall he charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a raCe set annuaily by an administrative
policy. it shali be the responsibitity of the applicant,owner,accupant 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 senrice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land orproperty. (Ref 638,1156,1191).