Meter Swap �� ;�-r 5�.-Y�-����,
� L�'��� INSTALLATION �
a�nroF AUTOMATIC METER READER
FRIDLEY
Address �Lc ) 1�V ��C��b'��t��
Name ��'CL�T �l CZl4►--`�
Date�� ��- ��
Old Meter Number �-/ �
Old Meter Reading � � >�
Replacement Na . l���
Replacement Reading �
Replacement Make_����
ERT# �r��{���� v
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridiey 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 fram the main to the premise and all interior plumbing. (Per City code
402.06) f 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 to;valves,piping,walis,floors or the curb
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Finai meter reading(old meter� ��c 4 �
�
Name: Address: t�1 La `� �F����`�
Phone Number. Date: J � �-J���
Signature:
. WitnessSignature: 9r=�"""� ` .
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewe�line connecting the existing municipa!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 shall pay a permit fee as provided in Chapter il of this Code. After such connection has been
made,the Water and Sewer Department shail be notified. it shall be un{awful to cover any conr�ecti�g line until an
inspection has been made and such connection and the work incident thereta has been approved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNEC7'ION
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 fine and sewer lines
necessary for connection of the premises from the main to the premises. lf the property owner requests
maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the
maintenance and/or repairs, including any necessary st�eet repairs,at a�ate set annually by an administrative
policy. 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 servi�e curb stop box for operabitity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)