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U.N�. AUTOMATfC METER RE�►DER
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Replacement Reading Q'4
Replacement Make � "''r�.
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Replacement ERT#
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City of Fridley
Water Department
6431 UniversityAvenue NE
Fridley,MN 55432
(763)572-3566
1/we hereby authorize the City of Fridley andJor its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all inte�ior plumbing. (Per City code
402.06j 1 also hold the City of Fridtey and/its employees harmless for any damages that may occur
white doing this operet+on. This to include,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. I understand I am also�equired to obtain a permit prior to any work,if
necessary.
final meter reading(old meter} ���� ���
Name: Address: IE'l�a� ��y��
Phone Number. Date: �^���r,�" �
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Signature:
. Witness Signature: . .
FRIDLEY CITY CODE
CHAPTER 402.WATER,570RM WATER,AND SANITARY SEWER
AdIVIINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,92z,988,1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipa(system and any house
or building for which the application is made,the owner or contractor shall 6e 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 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 suitable connection.
4�2.06. REPAIRS AND MAINTEN/�NCE TO CONNECTION
After the initiat connection has been made to the water service curb stop box or the sewer lead at the property
line or a water se►vice 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 repairs required to any water line and sewer lines
necessary for cannection of the premises from the main to the premises. lf 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 a�d/or repairs, including any necessary st�eet repairs,at a rate set annually by an administrative
poficy. It shall be the responsibility of the applicant,owner,occupant ar 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 operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,Ii56,1191)