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v.R,oF AUTOMATIC METER READER
FWDLEY
Address ���lJ � t��-E.��:.� 1`�.
Name ��UC, bt�L-�.1f�Q.�
Date � '�.�' �.FT
Old Meter Number [b�`? 3g o`z
Old Meter Reading
Replacement No. �
Replacement Reading C�
Replacement Make
ERT# � �. ��'
Replacement ERT#
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
t/we hereby authorize the City of Eridley and/or its
emp{oyees to do what is necessary to rep{ace the water meter. I understand that the properly owner
is liable for tfie water line frorn the main ta the premise and alt interior plumbing. (Per City code
402.06j i also hold the City of Fridtey and/its employees harmless for any damages that may occur
while dcing this operat+on. This to inctude,but not limited to;valves,piping,walls,floors or the curb
� stop box and service line. l understand 1 am also required to obtain a permit prior to any work,if
necessary.
t r readin old meter � �� ����
Final me e �( 1. �
Name• Address• � '� Y�-
Phone Number: Date• �"'�� J� —
Signature:
. Witness Signature: .
FRIDLEY CITY CODE
CHAPTER 402.WATER,S70RM WATER,AND SANITARY 5EWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1155,1191)
402.05. PERMfT FEE
Prior to canstruetir►g oc repair of any water or sewer line co�necting the existing municipal system and any house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. ARer such connection has been
made,the Water and Sewer Department shall be notified. It shail 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 T�CONNECTtON
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 sha11 be charged for the costs of the
maintenance andJor repairs, including any necessary street repairs,at a rate set annual{y by an administrative
policy. ft shall be the responsibility of the appficant,owner,occupant or user to perform standard maintenance of
• the sewer service line from the prem9ses to the main including debris ciearing or�oot cutting and to maintain the
water service cur6 stop box for ape[ability and at such height as wiil ensure that it remains above the finished �
grade of the land or property. (Ref 638,1156,1191)