Meter Swap �� . )��������7>�
� C`�/��-��" INSTALLATION
�.n� AUTOMATIC METER READER
FRIDLEY
Address���� �� �
_ Name � `�*Rl ��L���
Date ��y���T �'
Old Meter Number
Old Meter Reading �� ���
Replacement Na � ��
Replacement Reading 5�'
Replacement Make
ERT# `�_ , � � ,,�1
Replacement ERT#
Remarks:
-7��� Signed:
R�t�s� f�vf�en�+e R
, �ii�y af Frid�y
F;�# 1�: �9�-12- �te: �12sl��2
T�,e= �r �- �Y
t3e�a�: W� C'+ .�t�se: t��er
Ad�� 5�19 1111�!� _ 763��-�419
[?at�e= 6�l''�7f�D1�"�tt!!PM^ ���' t3�erer:
L�t[letaiis: Request Dda�s: A�
�nn"�a�ase:
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t�{�i r��din�: �Q`� C� ��
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� r City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)57�-3566
1/we hereby authorize the City af Fridtey 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 fram the main to the premise and all interior plumbing. (Per C�t1►code
402.U6) I a(so ho{d the City of Fridtey and/its employees harmless for any damages that may occur
while doing this operation. 7his to include,but not limited to;valves,piping,wails,floors o�the curb
stop box and service line. I understand I am alsa required to obtain a permit prioc to any work,if
necessary.
Final meter reading(oid meter}
� �� ���
Address: �� �F��\
Name: .
Phone Number: Date: � ��^ � �
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Signature: � �
_ Witness Signature:_ �"� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANtTARY SEWER
ADM1N{STRATI�N
(Ref Ord No 113,464,565,566,629,638, 662,922,988.1144,1156,1191)
402.05.PERMfT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipa(system aad anq house
or 6uilding 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 VVater and Sewer Department shall 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 suitabie connectian.
402.06. REPAIRS AND MAIN7ENANCE TO CONNECTiON
After the initial 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 tead 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(ine and sewer lines
necessary for connection of the premises from the main to the premises. tf the praperty owner requests
maintenance service or repairs be performed by the City,the property owner shall he charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a raCe set annualfy by an administrative
policy. !t shal{be the responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the sewe�se�vice line from the premises to the main including debris clearing or root cutting and to maintain the
water setvice curb stop box for operability and at such height as wi14 ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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