Meter Swap '� C��-�`�? r���I �S'-4���5��
INSTALLATION
v.R,� AUTOMATIC METER READER
FRIDLEY
Address ���i ����� �
Name 11 i�C�- ���K-`=�
Date ���,��
Old Meter Number�
Old Meter Reading �
Replacement No. ��d.T l o����
Replacement Reading �
Replacement Make ����
ERT# ���� ��� �
_Q�a� _��_
Replacement ERT#
Remarks
?SS� Signed:
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� �',�`'✓�� INSTALLATION
unroF AUTOMATIC METER READER
FRIDLEY
Address �rJ� �������Tr ��
Name �`� ��tt—�('�'(�,�-;IJ
Date 5 �- l�— ��,-� �
Old Meter Number �� ���
Old Meter Reading
Replacement No. ��� �(F3�
Replacement Reading�
Replacement Make
ERT#���� Lh"1�
Replacement ERT#
Remarks
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/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 ali interior plumbing. (Per City code
402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur ,
while doing this operation. This to include,but not limited to;valves,piping,wails,floors or the curb
� stop box and service line. I understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter) ���� �� �
,
Name� Address:�j��i�T v���
Phone Number: Date: '� �
;
Signature:
Witness Signature: �
�
FRIDLEY CITY CODE i
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER '
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988, 1144,1156, 1191}
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402.05. PERMIT FEE i
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Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any�tint4se !
or building for which the application is made,the owner or contractor shall be required to obtain a permitfiir�'�h I
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 shalt 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.
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 service 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 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 shali be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annuatly 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 operability and at such height as witl ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191�
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