Meter Swap '= ;����"�-- i�%?�'l(.�S`'��15�1Nv
INSTALLATION
G.�� AUTOMATIC METER READER
FRIDLEY
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Address �� t' ��= �-� ��
Name �t�v�M�/ � (��
Date ����1 � �.
(Jld Meter Number � l�- �
Old Meter Reading
Replacement No. _
Replacement Reading�
Repiacement Make � �
ERT# `)� 4� ��
Replacement ERT#
Remarks:
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorixe the City of Fridtey and/or its
empluyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and ali interior pfumbing. (Per City code
402.06j I also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This ta include,but not limited to;valves,piPing,walls,floors or the curb
stap box and service line. I understand I am aiso required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meterj � � � �
Name• Address: �,r� �"�
Phane Number; Date: � �-� `� �
Signature:
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. Witness Signature: .
FRIpLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
� ADMINISTRATIQN
(Ref Ord No 113,464,565,566,624,638,662,922,48g, 1144,1156, 1591�
40Z.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipat system and any hause
or 6uifding for which the application is made,tfie owner or contractor shall be required ta obtain a permiC for such
connection,and shal{pay a permit fee as provided in Chapter 11 of this Code. After such connectian has been
made,the Water and Sewer Department shall be s►otified. It shall be unlawful to cover any conneding 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.
402.06.REPAIRS AND MAINTENANCE TO CONNECi'ION
After the initial connection has been made to the water service curb stop box or the sewer lead at the p�operty
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 p�emises shal{be liable for a{I repairs required to any wate�(ine and sewer lines
necessary for connection af the premises from the main ta the premises. If the property ow�er requests
maintenance service or repairs be pertorrr►ed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, inc{uding any necessary street repairs,at a rate set annuatly by an administrative
poficy. ft shall be the responsibility of the app{icant,awner,occupant or user to perform standard maintenance of
' the sewer service line from the premises ta the main including debris clearing or root cutting and to maintain the
water service curb stop bax for operabitity and at such height as will ensure that it cemains above the finished
grade of the land or property. (Ref 638,1155,1191)