Meter Swap '� �"/t`tS-���iUl v
� (`J,�--�', INSTALLATION
�N� AUTOMATIC METER READER
FRIDLEY
�Address �►�t '1 V���L-�'tZ'�
Name ����Z- ! ��A�C11�Zi
Date ����{ .�. ��
Old Meter Number ����
Old Meter Reading �
Replacement No. l �
Replacement Reading �
_
Replacement Make_,C`��oG�` / _ —
ERT# ��:1� � ���?�
Replacement ERT#
Remarks:
��,�..� Signed:
F�€�q�t f�r�r� i��r#
�i�y a�f F�idiey
�; ��-�2 t��: �7rz+��2
T�� ,�t� ��
��: �u� �►r�� ��
�= s+���rr� sr e� . ��-�as
s�a�: ����o-��w�_��,K , �►t�:
��: ��= ,+�
�
�Id �Vl��r# � `��j L� �
� �
�
�Ici r�a�dir��. <.7��- ��� C�f�
.�,..
�U��r �I��r# �'�$� I ZC?�
t�+�w F��ding: �
���# ���� ���
�
_ ; �
� �_�_.___ _.�.�� K_�_ ��______._�---_ __�..�__.._.�_____ �
� �
���_m_ _____.___�___r_____ _______
�„�_ ----� �
.�-.��-1�� �e� �
� _
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
employees to do what is necessary to replace the water meter. I understand that the property owner
is liabie far the water line fram the main to the premise and all interior plumbing. (Per City code
402.06) I also hold the City of Fridiey and/its emptoyees harmless for any damages tha#may occur
white doing this operat+on. This to include,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. 1 understand I am also required to obtain a permit prior to any work,if
necessary.
Fina!meter reading�old meter) �
Name: Address:�t� \ ��v��N
Phone Number: Date: � a` `` ��
Signature: `
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,624,638,662,922,988,1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing murticipa!system and any house
or buildi�g for which the appfication is made,the owner or cpntractor shall be required to obtain a permit for such
connection,and shal)pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Repartment sha(I be notified. it shali 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.
4U2.06. REPAIRS AND MAINTENANCE T�CONNECTION
ARer the initial connection has been made to tF�e 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 appiicant,owner,
or the occupant or user of such premises shail be liable for ali repairs required to any water line and sewer tines
�ecessary for connection 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 sha{I be charged for the costs of the
maintenance and/or repairs, including any necessary st�eet repairs,at a rate set annuafly by an administrative
policy. It shall be the responsibi(ity of the applicant,owner,occupant or user to perform standard maintenance af
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,I156,1191)