Meter Swap '� � j {���a�t5 -5`t��z
� ��"`� INSTALLATION
��.N� AUTOMATIC METER READER
FRIDLEY
Address ��� �J'���� �
Name V'�Cio�t:., 1''►������1
Date �3--- ��'�— � d�
Old Meter Number � �J�`o�3
Old Meter Reading � �
Replacement No. �Pv�F �C��S ��
Replacement Reading �
Replacement Make �
ERT# J7�7 � o��. �
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 af 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 to the premise and all interior plumbing. (Per City code
402.06� i also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this aperation. This to include,but not limited to;valves,piping,walls,floors or the curb
� stop box and service line. i understand I am aiso required tv obtain a permit prior to any work,if
necessary.
Finai meter reading(old meter) l�� 1� �� —
Name: Address: � (�������. ��
Phone Number: bate: �✓� t�I�_
Signature: '
Witness Sign re:
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. PERMIT 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 appiication is made,the owner or contractor shall be requi�ed to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connectio�i has been
made,the Water and Sewer Department shall be notified. it shall be unlawful to cover any connecting�ine until an
inspection has been made and such connection and the work incident thereto has 6een 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 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 accupant or user of such premises shall be liable for ail repairs required to any water line and sewer lines
necessary far connection of the premises from the main to the premises. If the property owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the casts 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 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 cur6 stop box for operahility and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)