Meter Swap � ��`�� IN�S A T O���v
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�� AUTOMATIC METER READER
FRIDLEY
Address >�-6� �'���� ��`�-
Name ` 1�`�� ��Am��S.�—
Date �b ��' `r�
Old Meter Number � �'j �
Old Meter Reading � ��
Replacement No. � � - `
Replacement Reading�
Replacement Make ����
ERT# ���� Q��1�J
Replacement ERT#
Remarks:
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FRIDLEY
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Date ����''�
Old Meter Number . � 4 � `i �
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Old Meter Reading � ! _ -7�.-�
Replacement No.��� ���'�2����'�Y
Replacement Reading�
Replacement Make �
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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
{[we hereby authorize the City of Fridiey and/or its
emplayees to do what is necessary to repiace the water meter. i understand that tfie property owner
is tiable for the water line from the main ta the premise and afl interior plumbing. (Per City code
402.06) 1 aiso hoid the City of Fridley and/its employees harmless for any damages that may accur
while doing this operation. This to include,but not{imited to;valves,piping,walis,ftoors ar the curb
� stop box and service line. t understand 1 arn atso required to obtain a permit prior to any work,if
necessary. � �
� �
Final meter readin old meter � k/
gl �
Name• Address:��� ����"� `�`'�
Phone Numbe • Date: J����_
Signature: �
Witness Signatu :
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 water or sewer line connecting the existing municipal system and any house
or building for which the applicatian is made,the owner or contractor sha{I be required to abtain a permit for such
connectien,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 cvnnecting 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 connection.
402.06. REPAfRS AND MAINTENANCE TO CONNEC7'ION
After the initiat connection has been made to the water service curb stop box or the sewer{ead at the property
4ine ar a water service or sewe�{ead has been extended to the property{ine for connection,the applicant,owner,
or the occupant ar user of such premises shalt be 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 pertormed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, includin�any necessary street fepairs,at a rate set annually by an administrative
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 maintain the
water service curb stop box for operabifity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191}