Meter Swap � ��-1� I�S AL�LATION��v
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u.N� AUTOMATIC METER READER
FRIDLEY
Address �i��� �=�`11r'� ��
Name ��� ��b.-�l`�
Date ���'�� ��
Old Meter Number � I �
Old Meter Reading � � b�'
Replacement No. �C �
Replacement Reading�
Replacement Make ���3t�'�.
ERT# .1 .)?JQ �� ���/
Replacement ERT#
Remarks
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� ' City of Fridley
Water Department
6431 University Avenue NE
Fridley, MN 55432
(763]572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to repface the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior plumbing. (Per City code
44Z.05} {a{so ho{d the City of Fcidley and/its employees harmless for any damages that may occur
while doing this operation. This ta include,but not timited to;valves,piPing,walls,floors or the curb
� stop bax and senrice line. I understand I am also required to obtain a permit prior to any wark,if
necessary.
Final meter reading(old me�ter)
�� �
Name: Address:_,_��� ��� v�
Phone Number: Dafie: `� •
� Signature:���Z@��At'_ .�.('�-v�-�
. Witness Signature: .
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SAN(TARY SEWER
pDM11N15TRATION
(Ref Ord No 113,464,565,566,629,638,662,422,988,1144,1156,1191}
40�.05. PERMtT fEE
Priar to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the applicatian is made,the owner or contractor shall be required ta obtain a permit for such
�on+�ee�+en,an�shall�aT���rmit fPP ac nrovided in Chapter 11 of this Code. ARer such connection has been
made,the Water and Sewer Department shall be notified. It shafl be unVawful ta cover any con�e ing in u "
inspection has 6een made and such connection and the work incident thereto has been appraved by the City as a
proper and suitab{e connection.
4�2.Ofi. REPAIRS AND MAINTENANCE TO C�NNECTION
After the initiat connection has been made ta the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been e�ctended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall 6e liable for all�epairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property owner requests
mai�tenance service or repairs 6e performed by the City,the property owner shall he charged for the costs of the
maintenance and/or repairs, including 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 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 Che land or property. (Ref 638,1156,1191)