Meter Swap '_ �, • %t.%�74` �'�l-�-7;�.���
� =J�"�f� INSTALLATION
�.N� AUTOMATIC METER READER
FRIDL�.1'
Address �� �Pd�LC�
Name � �,,AG��1•5
Date �`� ti�
Old Meter Number=`��J�$'�J��
Old Meter Readin �3�
Replacement Na �
Replacement Reading �
Replacement Make � ^�
ERT# ��� �33�
Replacement ERT#
Remarks:
-1��y Signed:
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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
402.06) I alsa hold the City of Fridley andJits employees harmless for any damages that may occur
while doing this operation. This to include,but not limited 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 reading(old meter) � � �����
Name: Address �_ ����
Phone Number: Date: ��—,�
Signature: /'�"""
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
{Ref Ord No 113,464,565,566,629, 638, 662,922,988,1144, 1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any wafer ar sewer line connecting the existing municipal system and any house
or 6uilding for which the appfication is made,the owner or contractor shatl 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 6e notified. It shall be unlawful to cover any connecting line until an
inspection has been made and su�h conne�tion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06. 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 property
line or a water senrice 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 iine and sewer lines
necessary for connection of the premises from the main ta 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 and/or repairs, including any necessary street repairs;at a rate set annually by an administrative
policy. 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 or root cutting and to maintain the
water se�vice 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)