Meter Swap if7a-ys-Y���r3J
'� ���� INSTALLATION
�.N� AUTOMATIC METER READER
FRIDLEY
Address j��(� ��1�' �'�� ���,
Name -�1� ��AT�}
Date_���'- 1 c�i ,�����--,�..��j u��
Old Meter Number � � .�
O{d Meter Reading
Replacement No. —I ,�,�� ����
Replacement Reading � .
Replacement Make
E RT# ���� t O�� �
Replacement ERT#
Remarks: ���Q� ����
7� Signed: � _
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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/ar its
empinyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line trom the main to the premise and all interior plumbing. (Per City code
402.06) (also hold the City of Fridley and/its employees harmless for any damages that may occur
white doing this operation. This to inctude,bat not limited to;vatves,piping,wal(s,flaors or the curb
stop box and service line. 1 understand I am also required ta obtain a permit priar to any work,if
necessary. v � e:�
Final meter reading(old meter� �
Address:_ � �?� `—����� � �`
Name� .
Phone Number: Date: w—�� 1� •
� Signature:
. Witness Signature: . . �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANfTARY SEWER
ADMINISTRATtON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191}
4dZ.05. PERMtT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anjr house
o�6uilding for which the application is made,the owner or contractor shall be required to obtain a permitfar such
coCifl2E�TQn,and shall-Pa���-Permit fPP a�nrovided 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 conne ing�in ���
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitabte connection.
402A6. REPAIRS AND MAINTENANCE TO CaNNECTION
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 shalt be liab4e for all repairs required to any water line and sewer lines
necessary for cnnnection of the premises from the main to the premises. lf the property ouvner requests
maintenance service or repairs be performed by the City,the property owner shall 6e 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 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 638,1156,1191)