Meter Swap '- � '°��� \µ�`� : :.; 1;`i `;
� � +-'�" ` INSTALLATION
G.n,o� AUTOMATIC METER READER
FRIDLEY
Address�,���3 ��..1���7d�
Name �� �C�'f�N�
Date �"�—��
Old Meter Number �� i�� � �
Old Meter Reading ��
Repiacement No. � 1�
Replacement Reading �
Replacement Make ���
ERT# ���� , � � l
Replacement ERT#
Remarks:
•-���� Signed:
. F��qt� fia�S�r�+►ic:e R�p�rxxt
' �i�y a�f F�iif�y
f� , �: �1-12 [?�e� '5�`�/20�2
T�e: A�IR areE+er �.
f#��: Wat�r �Ala�aee !�+�aci
Add�: �'37�t Y�/�i�iGl'�N ST i�iE . 7�57�-��TT
S�ed�irxd�: �lZ�121�P'M ���� �jr C?��
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Rec�ie�t Dieia�s: /li�t
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�ev� ��adin�. �j
ERT� ���� ���.
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City of Frid{ey
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley andJor its
empioyees to do what is necessary to replace the water meter. I understand that the property owner
ls liable for the water line from the main to the premise and ail interior ptumbing. (Per City code
4�2.06) i aiso hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operetion. This to include,but nat limited to;vaives.piping,walls,floors or the curb
� stap box and service line. f understand 1 am also required to obtain a permit prior to any work,if
necessary.
Finaf ineter reading(otd meter) ��� �
Name: Address: ��� ��1���
Phone Number: Date:, ��`��
Signature:
� �
. Witness Signature: 1����
FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMiNISTRATION
(Ref Ord Na 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 municipa{system and any house
or 6uilding for which the apptication is made,the owner or contracta�shall be requifed�o obtain a permit for such
connection,and shal)pay a permit fee as provided in Chapter 11 af this Code. After such conaection has been
made,the Water and Sewer Department shall be notified. It shall be uniawful to cover any connecting line untii an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable cannection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTtON
After the initlal tonnection 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 ilne for connection,the appficant,owner,
or the occupant or user of such premises shalt be fiabte for all r,epairs required to any water line and sewer lines
necessary for connection of the prem9ses from the main to the premises. If the property owner requests
maintenance serviee or repairs he pertormed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary st�eet repairs,at a rate set annually by an administrative
poticy. ft shail be the responsibility of the appiicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main inc{uding debris clearing or root cutting and to maintain the
water senrice curb stap box far operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)