Meter Swap '� �,- -;2�� J � '��%'��' "`1'�`j3�-��,/
� L'�" INSTALLATION
G7YOF AUTOMATIC METER READER
FRIDLEY
Address �)�� � � ��%' �=J���
Name__����"fZ,7 ���,A�1�:
Date :>—�����
Old Meter Number � � �
Old Meter Reading � .T �
Replacement Na � �� �
Replacement Reading (�
Replacement.Make���
ERT# �l r ,.�l � n��c�� �
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Replacement ERT#
Remarks:
��5� Signed:
. R��t f�r Ser�ric�e R
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��t: Wat�er G6i��e. ��
Add�: �1 Y1�1 BI�REN ST[� . 76��.�7'�16
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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 Fridley and/or its
empluyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabte for the water line frarn the main to the premise and all interior plumbing. (Per City code
40Z.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur
white doing this operation. This to include,6ut nat limited tv;�alves,piping�walls,floors or the curb
� stop bax and service line. I understand I am also required to obtain a permit prior to any work,if
necessary. ,,.� �
Finat meter reading(old meterj �� �� � �
Address: ��� \ ��
Name: —
Phane Number: Date: `� ���� •
Signature:
. Witness Signature: .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STQRM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113r 464,565,566,629,638,662,922,988,1144�1156, 1191)
402.U5. PERMl7 FEE
Priorto 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 owne�or contractor shall be required to obtain a permit for such
connection,and shall pay a permit fee a5 provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. it shafl be unlawfu{to cover any connecting line until an
inspection has 6een made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
4D2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial coanection 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 ta the property line for connection,the applicant,owner,
or the accupant or user of such premises shall be fiable for a11 repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property awner requests
maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the
maintenance and/or repairs, including any�ecessary street repairs,at a rate set annually by an administrative
po�icy. It shall be the respansibility of the applicant,owner,occupant or user to pe�form standard maintenance of
the sewer service line from the premises to the main inctuding debris clear9ng 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)
a