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�'.�� AUTOMATIC METER READER
FRIDLEY
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Name � QI' � (,/"V�-�q, -�.5��►
Date ���.�'� �a'
Old Meter Number r � ���
Old Meter Reading � l l t � �
Replacement No. �� v �
Replacement Reading �
Replacement Make "'
ERT#�� �c�� � � -
Replacement ERT#
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" City of Fridley
Water Department
6431 University A�enue NE
Fridley, MN 55432
(763�57�-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line fram the main to the premise and all interior plumhing. (Per City code
402.06) t also.hold the City of Fridfey and/its employees harmless for any damages that may occur
white doing this operation. This to include,but not limited to;valves,piping,walls,floars or the curb
stop box and service line. I understand 1 am also required ta obtain a permit prior to any work,if
necessary.
Final meter reading(old meter� �
Name: Address: � \
Phone NumberE��_l�Date: ����' 2 •
• Signature: �°j^'n' ��
r_ o..
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,570RM WATER,AND SANITARY SEWER
pDMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.05. PERMIT FEE
Prior to constructing or repair of any water or sewer Iine connecting the existing municipal system and any house
or building for which the application is made,the owner dr eontractor shall be required to obtain a permit for such
sanr�es�ier�,-an�shaff-Sa�r�-rgrrn�t fPP as nrovided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawfu(to cover any conne ►ng�in "
inspection has been made and such connection and the work incident thereto has been appraved by the City as a
proper and suitable connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initiat connection has been made to the water service curb 5top box or the sewer lead at the praperty
line or a water service or sewer lead has been extended to the property line for cpnnection,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 for connection of the premises from the main to the premises. lf the properly ovvner requests
maintenance service or repairs 6e performed by the City,the property owner shall 6e charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a raCe 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 such height as wi�l ensure that it remains above the finished
grade ofthe land or property. (Ref 638,1156,1191)