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�� INSTALLATION
G.NOF AUTOMATIC METER READER
FRIDLEY
Address �� ��.i �\�lL-�'�
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Name � �{�1�1.ys�
Date �-�� - ��
Old Meter Number �� � 1
Old Meter Reading �J �� �
Replacement Na �J�� �-1oq
Replacement Reading��
Replacement Make T�.l-�
ERT# ���� � �� I ✓
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
1/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water tine from the main to the premise and ail interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur
white doing this operatian. This to include,but not Itmited to;valves,piping,walls,floors or the curb
� stop bax and service line. 1 understand I am also required to obtain a permit prior to any work�if
necessary.
Final meter readi�g(old meter) ���.�����
Name:
Address ' � ��"�'���
Phone Numbe
Date: ��� �
Signature•
. Witness Signature:
FRIDI.EY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building fo�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 Department shall be notified. It shall be unlawful to cover any connecting line until an
inspection has 6een made and such connection and the wosk inc9dent thereto has been approved by the City as a
proper and suitable connection.
402.05. REPAIRS AND MAINTENANCE TO CONNECTION
After the initlal 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 tine for connedion,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 shall be 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,owne�,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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
Request for Service Repart
, City of Fridley
Reference No: 601-11-2985 Date: 04/14/11
Request Type: Turn waker aFflon Entered By: Wendy Hiatt
Department: Water Citizen Name: DavefAqua City Plumbing
Address: 6330 JACKSON ST NE Callback Phone: 612-827-2871
Scheduled Date: 04I75111 9=00 AM �.�•����g�: Properky Owner: DeanJohnson
Locakion Details: Leave key in standpipe �' Request Details= Shut waker oFffleave key
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Permit#2011-00451
Action Taken:
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Responsible Person: i ��
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Approuer:
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Complekion Date: � �Citizen Notified
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