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'� �'`�"��, INSTALLATION
�.�� AUTOMATIC METER READER
FRlDLEY
Address � .��., a
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Name �R�l� �1�"��
Date 1���` ��
Old Meter Number � _ � l��
Old Meter Reading � l o��
Replacement No. �� ����
Replacement Reading �
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ERT# ��J�C� ��j�� ✓
Replacement ERT#
Remarks
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1 City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
�/We hereby authorize the City of Fridley andjor its
employees to do what is necessary to replace the water meter. i understand that the property owner
is liable for the water tine from the main to the premise and all interior plumbing. (Per City code
402.06y i also hold the City of�ridley and/its employees harmless for any damages that may occur
whife doing this aperation. This to include,6ut not limited to;vaives,piping,wafis,floors or the curb
stop hax and service line. 1 understand{am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter) ��� ���
���Q �- ��� �-�
Neme: Address: -
Phane Number: Date: f�)" E�" ��
Signature: " ,�V✓����'��'"
. Witness Signature:
FRIQLEY CtTY CODE
CHAPTER 402.WATER,STQ�tM WATER,AND SANITARY SEWER
ADMfNtSTRATfON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.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 application is made.the owner ar contractor sha41 be 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 shaff be notified. It sha{f be unlawful to cover any connecting line unti{an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connectian.
402.06. REPAIRS AND MAfNTENANCE TO CBNN�CTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
fine or a water service or sewer lead has been extended to the property line for connection,the appiicant,owner,
or the occupant or user of such premises shall be liable for ali repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. tf the property owner requests
mainte�ance senrice 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 annually by an administrative
po(icy. It shal{be the responsibility of the appficant,owner,occupant or user to perform standard maintenance af
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)