Meter Swap '� ����� f ��;�--'-r�G�v
� INSTALLATION
G.��. AUTOMATIC METER READER
FRIDLEY
Address ` c � '11�.}( �/
Name ���� l E_� �-�
Date �~�•�''`�
Old Meter Number �� �S
Old Meter Reading � �
Replacement No. � (� , d
Replacement Reading �
Replacement Make `:�
ERT# �� � 0�� �
Replacement ERT#
Remarks:
���� Signed:
. ' ��qUest f�r Seruic�: R
�i�y af Frid�/
� �r: �t-12-d�C17 �a�: 5w'�?f2�12
�Tjtpe: Ir�a�'AM�t e�et� � E3�r: YV�d�+�
. YYa�es �i��� T�aryr Tid�
l�dd�s: �D f�I11N[..'1��T i� . fi12-419-�G43
Sehe�ie�d t�e= 5�1�il�i�2-tIQ Plil ' t3wRwer_
�EA�a�s: Reque�t �eta�s: N�
�1�arr Takden_
t���i �I+��r # f`] } "� �b� �'�
�Id r�a�din�: �L� ��,Q
�ler�r �Ae�r # ��`�>�, 17�
[�1+�w �+�dir�g. �
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 5543Z
� (763)572-3566 � -
�/We hereby authorize the City of Fridley 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 ta the premise and alf interior plumbing. (Per City code
40Z.06) i also hold the City af Fridley andjits employees harmless for any damages that may occur
while doing this operation. This to include,6ut not limited to;vaives,piping,walis,floors or the curb
� stop box and service line. 1 understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old metec)
�� �
Name: Address: �L,/�� �
Phane Number: Date: ��`�'� �
Signature: / �i ���
. Witness Signature:_,�\_��� .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144, 1156, 1191)
402.05. PERMtT FEE
.`
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and 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 V1/ater and Sewer Department shall be notified. It shall be unlawfu)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.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
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 senrice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be 1ia61e for all�epairs required to any water line and sewer iines
necessary for co�nection of the premises from the main ta the premises. If 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, including any necessary street repairs,at a rate set annuaily by an administrative
policy. It,shali 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 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 638,1156,1191)