Meter Swap � �'��1' INS ALLAT OcN ���
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u-nroF AUTOMATIC METER READER
FRIDLEY
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Name ���� �.P���'�
Date �""���
Old Meter Number ��
Old Meter Reading a�
Replacement Na 'r'J 1 d��'{ �
Replacement Reading�
Replacement Make �'�Pt���
ERT��C7 �� '✓
Replacement ERT#
Remarks
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City of Fridtey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
employees ta do what is necessary to replace the water meter. I understand that the property owner
is liabie for the water line 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
while doing this operation. This to include,but not limited tu;valves,piping,walls,floors or the curb
� stop box and service line. I understand{am aiso required to abtain a permit prior to any wark,if
necessary.
Final meter�eading(old meter� �. ��` g
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Name• Address �(�1�.._� �, --
Phone Number• Date: � )-"`�
Signature• /ti" .�����-�
. Witness Signature:
FRIDLEY CtTY 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
Priar to constructing or repair of any water or sewec line connecting the existing municipat system and any house
or building for which the appiication 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 uniawful 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 suitabte connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
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 far connection of the premises fcom the main to the premises. If the property owner requests
maintenance service or repairs he pe�Formed by the City,the property owner shall be charged for the costs of the
mainfenance and/or repairs, including any necessary street repairs,at a rate set annuatly by an administrative
po(icy. It shall be the responsibility of the applicant,owner,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 bax for operahility and at such height as witl ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191�