Meter Swap '= ��� / 7 S�t�'�-yC��3�:3��
INSTALLATION
u.R,o� AUTOMATIC METER READER
FR[DLEY
Address KJ I �� ����l\���
Name �t�%�Z� �t3��� �'��?
Date ���-1�
Old Meter Number � �
Old Meter Reading -t y�
Replacement No. �J�� t��'(
Replacement Reading �
Replacement Make
ERT# ��3 l ���Z�
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 of Fridtey and/a�its
employees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line fram the main to the premise and all interior plumbing. (Per City code
402.06) i also hold the City of Fridley and/its emplayees harmless for any damages that may occur
while doing this operation. This tu include,but not limited to;valves,piping,wafls,floars ar the curb
� stop box and service line. I understand I am also�equired ta obtain a permit prior to any work,if
necessary.
Finai meter reading(old meter� �� �
Name: Address: w f� `� �
Phone Number: Date: �~���� •
Signature:
Witness 5ignature:
FRIDLEY CfTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANiTARY SEWER
ADMINISTRATlQN
(Ref Ord Na 113,464,565,566,529,638,66Z,922,988,1144,1156,1191)
4Q2A5. PERMlT 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 pravided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful 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.
4a2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection fras been made to the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall6e liable for ail�epairs required to any water fine and sewer lines
necessary for c�nnection of the premises from the main to the premises. tf the property owner request�
maintenance service or repairs be 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 rate set annually by an administrative
poticy. It shall be the responsibility af the applicant,owner,occupant or user to perform standard maintenance of
the sewer se�vice(ine from the premises to the main including debris clearing or root cutting and to maintain the
water ser�ice 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