Meter Swap '= ,� � � ��s- �> �:ki
(,�= INSTALLATION
G7YOF AUTOMATIC METER READER
FRIDLEY
Address�l'7C)� ����
Name l�i�`� ����
Date � � (�
Old Meter Number ��r��
,
Old Meter Reading � ��� �
Replacement No. �� �� S�
Replacement Reading �
Replacement Make '
ERT# � ��� � �� _
Replacement ERT#
Remarks
Signed:
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T�� trrstaU A�ise�er �� �
. Ylta�r �1+#a�e: ��€a�
,�d�s� � IA�� F�ae�e: �12'-�iQ-$675
s�a�: ��t��.-aow��`h�f� °�"�
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!�ici Me�r # 8��� �b��'(`l
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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. I understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
4UZ.06) 1 alsa.hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but nat fimited ta;valves,piping,wails,floors or the curb
� stop box and service Ilne. i understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(otd meter� � � ����
Name: Address: 1d7�v ����`
Phone Number: Date:___�sf — ��=-- �
Signature:�L�,��'n��/ l
. Witness Signature: �� .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANtTARY SEWER
ADMINISTRATION
(Ref Ord No 123,464,565,566,629,638,662,922,988,1144,1156,1191}
402.05. PERMIT FEE
Prior to constructing ar repair of any water ar sewer line connecting the existing municipal system and any house
or huilding for which the application is made,the owner or contractor shail be required to obtain a permit fnr such
connection,and shal)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 notifled. It shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the wvrk incident thereto has been approved by the City as a
proper and suitable connectian.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initia!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(ine for connection,the appl+cant,owner,
or the occupant or user of such premises shall 6e liable for all repairs 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 5hall be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set'annually by an administraCive
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 rnaintain the
water service curb stop box for operabiliry and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)