Meter Swap '�r ���-���-��-y��-�--�
� `� -�-��`� INSTALLATION
G.n,� AUTOMATIC METER READER
FRIDLEY
Address��'?C.` ����� ��
Name � ��� �C= !' ��c
Date_� � • -s"�'�=-
Old Meter Number � ` �>��� M
Old Meter Reading r`�' � � ��
Replacement No. �(X� C(�'+4'
Replacement Reading (f�
Replacement Make t� ''�
ERT# ������
Replacement ERT#
Remarks:
��7g Signed:
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City of Fridley
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 ta replace the water meter. 1 understand that the properly owner
is liable for"the water line fram the main to the premise and all interior plumbing. (Per City code
442.06} i also hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this operation. This ta include,but not limited to;valves,piping,wails,flaors or the curb
� stop box and service line. I understand l am also required ta obtain a permit prior to any work,if
necessary. '
Final meter reading(old meter) ,�� ' � ��
�'64� N���-.s-r
Name: Address_ �_
Phone Number: Date: ����—�� �
Signature: r
. Witness Signature: _
FRIDLEY CtTY CODE
CHAPTER 40Z.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,6�9,638,662,922,988,5144, 1156r 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anjl house
or 6uildi�g for which the application is made,the owner or contractor shall 6e requi�ed to obtain a permit for such
wnnection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer�epartment shall be notified. It shall be unlawful 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 suitable connection.
4�2.06. REPAIRS AND MAIN7ENANCE TO CONNECTION
After the initlal connectian 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 Ilne for connection,the applicant,owner,
or the occupant or user of such premises shatl be liable for all�epairs required to any water line 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 shall be charged for the costs of the
maintenance andJor repairs, including any necessary st�eet repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant ar 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 su�h height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191y