Meter Swap ... �� '. r, �:� _i:_t ,:r .�e.�'✓ � J
'� i� " ' � � INSTALLATION
�.N� AUTOMATIC METER READER
FRIDLEY
Address ���1,� ��,.��i�(,��TC►-4
Name ��� ��c LL-
Date �" l — ��
Oid Meter Number ���
Old Meter Reading ��y �
Replacement No. 3 a�"��S
Replacement Reading �
Replacement Make_��
ERT# � J�J �1��(� '�
Replacement ERT#
Remarks:
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� City of Fridtey
Water Department
5431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��w� hereby authorize the City of Fridley and jor its
empioyees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water{ine from the main to the premise and all interior plumbing. (Per City code
4�2.06) 1 a(so hold the City of Fridley and/its employees harmless for any damages that may occur
whi{e doing this operation. 7his tv include,6ut not limited to;vatves,qiping,walis,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.
Final meter reading(old meter� C^�� `�_J --
Name: Address: � /, l� ) �'V�S�►�j7d•�
Phone Number: Date: �_�`�'C�.�—
Signature:
. Witness Signature: 1'"dJ�'�
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STt?RM 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 municipaf system and anq house
or building for which the application is made,the owner or contrador shall be required to obtain a permit for such
connection,and shail pay a pe�mit fee as provided in Chapter 11 of this Code. After such connectian 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.
402A6. REPAIRS AND MAINTENANCf TO CONNECTION
After the initial connection has been made to the water service curb stop box ar 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 shall be liable for all repairs required to any water(ine and sewer lines
necessary for 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 shal!be charged for the costs 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 curb stap box for operabitity and at such height as wi{I ensure that it remains above the finished
grade of the land or property. (Ref 638,1156, 1191)