Meter Swap �'�(����-y7����j�i
'
���'� � INSTALLATION
G.N�. AUTOMATIC METER READER
FRIDLEY
Address �� �_) ( �t-iLi��'t�11�..�
Name �14a�� ��Si L.
Date tQ� ` � l p+�
Old Meter Number � •
Old Meter Readin �"1 � �
Replacement Na �
Replacement Reading �
Replacement Make ���
ERT#�s7�)���
Replacement ERT#
Remarks:
��,S.Y,� Signed:
. F��q��# f+�r�ervic�e R�rt
` �ity c�f Fridf�
�: +6�t-lz t�: 12
�
T�pe� ;�tl��eler �a:
C��: �1tat�r Cid�en�: �ne F�a�i
A�d�: 6�7'.LA�!ST�IE � ?�72-06�D
Sc#re�i�d D�e= ""'!'�6���3t#�i ,�"� �jr tAa�:
_ Lo—►—I 2 �
��= �
1�Ta�:
�}�� �+�'�r� � �
��{j C��{�il'��; � ��� ���
�
�
��+��'V ��E�.'�f� ��U�' �� ��
�
��':�Ili ��e3€�!�'tt�:
�E��-� ������
� ��
�
€
� �
�
,
� __ _�� _mm_ _W._. �__. __�_ �_ �__����m
���� ; �
_ .__�.�_ _�__._ �
G
_ ; �
�
�,�: �-- I -��� ��
�
- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby autharize the City af Fridley and/or its
employees to do what is necessary to replace the water meter, i understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
� 402.06) t afso hotd the City af Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,hut nat limited to;vaives,piping,walls,floors or the curb
� stop box and service line. 1 understand I am alsa required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) �� ��
f -� ,� �'��J
Name: Address• 1���
Phone Numher: Date: �� � �� •
Signature: `
. Witness Signature: ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,ST�RM WATER,AND SANITARY SEWER
ADMINISTRATI�N
(Ref Ord Na 113,464,565,566,629,638,6b2,422,488,1144,1156,1191)
402.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any i�ouse
or 6uilding for which the application is made,the owner or contractor shall be required to obtain a permit for such
connectlon,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 shail be notified. lt shall be unlawful to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the Cty as a
proper and suitable connection.
4U2.Q6. REPAIRS AND MAINTENANCE TO CONNECTIUN
After the initial connection has been made to the water service curb stop box or the sewe�lead at the property
(ine or a water senrice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall6e liable for all�epairs required ta any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
maintenan�e service or repairs be perFormed hy 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 annuatly by an administrative
poficy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer se�vice line from the premises to the main including debris clearing or root cutting and to maintain the
water senrice curb stop bax 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