Meter Swap '� d��R �s��x-K��r��
� INSTALLATION
�.��. AUTOMATIC METER READER
FRIDLEY
Address "�"'G�c ,� ��-�-�.�
Name ������1�C� ��A'�`{�,1
Date ct ' `�
Old Meter Number �l � �� �
Old Meter Reading �
Replacement No. ���p 1���
Replacement Reading�
Repiacement Make ��`��
ERT# ���� [J�� _4� �
Replacement ERT#
Remarks:
��� Signed:
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� City of Fridley
Water Department
fi431 University Avenue NE
Fridley, MN 55432
(763)572-3566
��W,� hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the properly owner
is liabfe for the water line fram the main to the premi5e and all intarior 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 inciude,but nat fimited ta;valves,piping,walls,floors o�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 readin (o(d meter) ��� `!'� '"v
g
Name; Address:� �� � !`��'�'�
Phone Number: Date: �r�`l� �
F
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, 1191j
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or huilding for which the application is made,the owner or contractor shall 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 Qepartment shall be notified. It shall be unlawful to cover a�y connecting line until an
inspection has been made and such connection and the wark incident thereto has been approved by the City as a
proper and suitable connection.
4U2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer tead 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�epairs required to any water line and sewer lines
necessary for cannection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs 6e 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 annualty by an administrative
policy. it shall be the responsibility of the applicant,owner,occupant ar user to perform standard maintenance of
the sewer service tine 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 638,1156,1191j