Meter Swap R��f f�r Serv'ia� F�+�r#
�'`,�fy a►f Frid�
�
i '
�tA: 6�1-�2`531'9 ��e: �'13/Z{��2
Tjpe= �t� ��E�y.
_ 9�ia� G�t�e� �an�
_ �pA�IS�I ST t� . 7�a7�-�0
S�re�d l�t�e_ 9e/13r��121�P�1 �� �t3�wx:
t � Re�q� . A�-t,eai�r�'
Ai�n Tak��
t�l�d �e#�r#� I �������
�id r�ading: � �� ����
�U�w �let+�r�# ��'� �`� 1 �
��e�nr �+�adir�g� �
i
���-� � r� �—� � � j , .
� � � �
;
�
� '
�_� _�_ �_______:�� ___ �...���_ ..__
���� � �__�.� __...____
� ,
s
�__ .._._�______�.�_._�___�_..___._ ____.�___________�______ __...
��: � — �
�= �:��-
,
,
� � City of Fridiey
Water Department
6431 University Avenue NE
, Fridley,MN 55432
� (763)572-3566
���ye hereby authorixe 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 fiable for the water iine from the main to tfie premise and all interior plumbing. (Per City code
402,06) I aiso hofd the City of fridley and/its employees harmless for any damages that may occur
while doing this ope�ation. This to include,but not limited to;valves,piping,walis,floors or the curb
stop box and servlce fine. t understand I am also required to obtain a permit prior to any work,if
necessary. �
Final meter reading(old meter) � � �' '��
Name� Address: � ` ���' �
Phone Number: Date: 1 � 1��� ��`
t
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER+402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRA710N
(Ref Ord No 113,464,565, 56b,629,638,662,922,988, 1144, 1156,1191)
402.05. PERMIT FEE
Priar to constructing or repair of any water or sewer line connecting the existing municipal system and any house
o�building for which the application is made,the owne�or contrector shall be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. tt 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 1
proper and suitable connection.
402.06. REPAIRS AND MAfN7ENANCE TO CONNECTiON
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
fine or a water service or sewer lead fias been extended to the property line far connection,the appl+cant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water line 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 shall be charged for the costs of the
maintenance andjor repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shail 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 cuttin�and to maintain the
water service curb stop box for operabitity and at such height as will ensure thaC it remains above the finished
�rade of the land ar property. (Ref 638,1156,1191j