Meter Swap '= �Jl� L� (ol�-tS=�7����
INSTALLATION
��.n,� AUTOMATIC METER READER
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Address �-� Y
Name 9 ► �� 4—� �A1.?�1�-��-�
Date '7`'��" ��
Old Meter Number
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Old Meter Reading � �C��
Replacement No. (� �� �
Replacement Reading �
Replacement Make -
ERT# ���� � _ l�
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley, MN 55432
(763)572-3566
�/We hereby authorize the City af Fridiey and/or its
employees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
402.06j i also hold the City of Fridley and/its employees harmiess for any damages that may occur
while daing this operation. This to include,6ut not Itmited to;valves,piping,walis,floors or the curb
stop box and service line. I understand I arn also required to abtain a permit prior to any work,if
necessary.
Final meter reading(old meter) � ��
Name: Address: �� u� ��N�-�
Phone Number: . Date: ����`�
Signature: " ' d
_ Witness 5ignature:
FRIDLEY CiTY CODE
CHAP7ER 402.WATER,STORM WA7ER,AND SANITARY SEWER
ADMINISTRA710N
(Ref Ord No 113,464,565,566,629,638,662,922,988,2144, 115b, 1191)
402.05. PERMIT FEE
Prior#o constructing or repair of any water or sewer line connecting the existing municipal system and anq hause
or buiiding for which the application is made,the owner or contractor sha11 be required to obtain a permit for such
connection,and shali pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shafi be notified. it shall be unfawfut 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.
4U2.06.REPA{RS AND MAINTENANCE TO CONNECTlaN
After the initial connection has been made to the water service turb stop box or the sewe�lead at the pruperty
line or a water service or sewer lead has been extended to the property line for cnnnection,the appiicant,owner,
or the occupant or user of such premises shall be liable for alt�epairs required to any water line and sewer lines
necessary for connection of the prernises 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 and/or repairs, incfuding any necessary street repairs,at a rate set annually by an administrative
po(icy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance af
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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j