Meter Swap �..I f ��j -�f S��t j 3-�.�;"
'� � �'��� INSTALLATION
u.��. AUTOMATIC METER READER
FRIDLEY
Address `�� J i 1���= S�.�
Name �.��1��.�/ �AL-��{
Date rJ"�� l c�
Old Meter Number � ��3
OId Meter Reading 4� .3�
Replacement No. � ����
Replacement Reading �
Replacement Make
ERT# �>`)e J� ��lq
Replacement ERT#
Remarks:
-7�� Signed:
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City of Fridiey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
IJwe hereby authurize the City of Fridley and/or its
emplayees to do what is necessary to replace the water meter. I understand that the properiy owner
is liable for the water line fram the main to the premise and alf inte�ior plumhing. {Per City code
402.06) f also hold the City of Fridley andJits employees harmless for any damages that may occur
whiie doing this operation. This to tnciude,6ut not limited to;valves,piping,walis,floocs ar the curb
� stop bax and service line. I understand{am also required to abtain a permit prior to any wark,if
necessary.
Final meter reading(oid metery ��� � ��Q
Name: Address: ��� �s�''� 5 t
Phone Number: Date:,���` ��
Signatere: �
Witness Signature:t`��r��,�
FRiDIEY CtTY CODE
CHAPTER 402.WATER,STQRM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156, 1191)
40ZA5, PERMtT FEE
Priar to constructing or repair of any water ar sewer line connecting the existing municipal system a�d 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 11 of this Code. After such connection has been
made,the Water and Sewer Department sha{I be notified. It shalf be unlawful to cover any connecting line until an
inspection has been made and such connection and the wark incident thereto has been approved by the City as a
prope�and suitable connection.
4Q2.06. REPAIRS AND MAlN7ENANCE TO CONNECTI4N
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 ser�ice or sewer lead has been extended to the property fine for connection,the applicant,owner,
or the occupant ar user of such premises sha{I be liable for all repairs required to any water tine and sewer fines
necessary for cannection af the prernises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shalf 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. tt sha{I 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 dearing�r root cutting and to maintain the
water service curb stop box for operability and at such height as wi{I ensure that it remains above the finished
grade af the 4and or praperty. (Ref 638,1156,1191)