Meter Swap � �`.������INSTALLAT ON�C���
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crnroF A�TOMATIC METER READER
FRIDLEY
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Name �C� ��sl��v 51�y
Date �`��— ��
Old Meter Number �
Old Meter Reading
Replacement No. ��� �� 3�
Replacement Reading (�/7
Replacement Make
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Replacement ERT# :
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` - City of Fridley
Water Department
fi431 University Avenue NE
Fridley,MN 55432
(763)572-3566
�JWe hereby authorize the City af Fridley andJor its
employees to do what is necessary to repfaca tha water meter, i understand that the property owner
is liable for the water line fram the main tv the premise and all interior plumbing. (Per City code
402.06} 1 a{so hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but nat limited to;valves�piping,walls,floars or the curb
� stop box and servica fine. t understand f am also required to obtain a permit prior to any wark,if
necessary. �
Final meter readin old meter �
� ��
B� I
Name: 1 Address: ��� ` �L�l�� -
Phone Number: Date: ����� �� �
Signature:
. Witness Signatuce:
FRIDLEY CITY CODE
CHAPTER�02.WATER,STQRM WATER,AND SAN{TARY SEWER
� ADMINlSTRATtON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1155,1191)
402.05.PERMIT FEE
Priorto constructing or repair of any water or sewer line connecting the existing mur►icipal system and anq house
or buildi�g 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 shali be noti�ed. it shall be unlawfu{to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the Cty as a
proper and suitable connection.
4Q2.Q6. REPA{RS AND MAINTENANCE TO CaNNECTION .
After the initial connection has been made to the water service curb stop box or the sewe�lead at the property
line or a water service ar sewer lead has been extended to the property fine f�r connection,the applicant,owner,
or the occupant o�user of such premises shall be liable for all�epairs required to any water line and sewer lines
necessary for cannection of the premi5es from the main to the premises. If the property awner requests
maintenance service or repairs be perFormed hy the Ciiy,the property awner sha11 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 responsibility of the applicant,owner,occupant or user to perform standatd maintenence of
the sewer secvice(ine from the premises to the main including debris clearing or root cutting and to maintain the
water service curb stop box for operabifity and at such height as wi{I ensure that it remains above the finished
grade�f the land or property. (Ref 638,1156, 1191j