Meter Swap '� � �.--�� �`7��sti� '�1'�L�����
� � INSTALLATION
G.R,o� AUTOMATIC METER READER
FRIDLEY
Address �n�U�_] �lC=���
Name LC»�.`� �1�t�=i.�
Date �o�- (�
Old Meter Number �0�
Old Meter Reading ( � 5
Replacement No. �oZ�J��
Replacement Reading �
Replacement Make��Q��
ERT# J��� ��SS
Replacement ERT#
Remarks:
�+�,� Signed:
, €���# f+�r�� R�ar#
T �i�y a�f F�icil�y
� �: �1-12-4�3+t �: 12
�Tj�e: ,�1Ft�et+e� !�r. '�� '
��E� Wat� �i ,��ae: I�a Ah� �lS 1`,j�
Acid�s: +�J 5��1E . ��-�2�7
S�d�te: �i�9_�t1 Jl�it t 1 ►� - �C�er: .
W
_ �qu�fl�cta�s: +!�
�ae 7af�=
�I�i �'let+�r#� o�
�Ici �a�din�� �, � i-� -��- �
�levv !l���r# �5`�I�SC��j :
��a�r F��ading: �
E�T# ������ ��J
�
�______. _�..__ ___ .. :.�__.______W_._. �_ .________�.._ _____._______w__.__ � ._
�.,�,�u��� i . I
�_...�_ ._..._.___�___._..___..__.._ __ ____ ._m____..__.._.1
E -
� �_..__.._______._�_ _.__ __ _ �____ __.��_�
��- �� +�'�
l.'__ i ��__��� ..._...._ ...... .... �
. �.......�.., .1�..... .�W.�:.
�
y
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 repiace the water meter. I understand that the property owne
is liable far the water line from the main to the premise and all interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its empioyees harmiess for any damages that may occur
while doing this operation. This to include,but not limited to;vaives,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 I
necessary.
Final meter reading(o!d meter) � ��5 5�O
Name� Address• W�� �E'����`�'"
Phone Number: Date: ���—��
Signature: �� � ���
Witness Signature:
FRIDLEY CITY C�DE
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.Q5. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shail be required to obtain a permit for suc
connectian,and shall pay a permit fee as provided in Ghapter 11 of this Code. After such connection has 6een
made,the Water and Sewer Department shail be notified. It shall be unlawful to cover any connecting line until a
inspection has been made and such connection and the work incident thereto has been approved by the City as a I
proper and suitabfe 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, I
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 secvice ar repairs be performed by the City,the prope�Cy 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�esponsibility of the applicant,owner,occupant or user to perf'orm standard maintenance of
• the sewer service line from the premises to the main inctuding 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)