Meter Swap Request Number: 9953
Public Works Division
Service Request
Problem Address: 6941 Hickory Dr Requested By: Dovna Wilson
Department: WATER Address: No address provided
Problem/LSsue: INSTALL AMR METER Phone Number: 571-0151
Schedule Date: 2015-04-1 Scheduled Time: 10:00:00
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ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2015-04-09
ACTION TAI�N:
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Status: In Progress Resident Contacted C1
Date Completed: Completed by:
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� City of Fridfey
- ._ ..., Wa#Pr Dppartment
6431 University Avenue NE �
Fridley,MN 55432
(763)57Z-3566
I/we hereby authorixe il��tY��'+diey and/or its
employees to do what is necessary ta replace the water meter. t understand that the property owner
._is_(iatile far the watier(ine from the main to the premise and all interior plumbing. (Per l�ty code
402.06) I.alsa hold the City of Fridiey and/'�ts employees harmless r any ama8es may ur-
while doing this operation. This tu include,but not limited to;vah��es►p�pi�g����5�flaors or the curb
stop box and service line. I understand i am also required to ahtain a permit prior to any wark,if
necessary.
Finai meter�eading(oid meter� I �� ���
Name•
Address: �� � �l C,�bQ� .
Phone Number• Date: ��`I�I''" .
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Signature: �"'���
Witness Signature:
. �RIDLEY CITY CODE
�{,qp�,�p2.WA'TER,STORM WATER,AM�SANITARY SEWER
ADMINISTRATICIN
(Ref Ord Na 113,464,565;566,629,638,662,922,988,1144,1156,1191)
4AZ.05.PERMIT FEE �
Priar to canstructing ar repeir of any vuater or sewer line connecting the odsting municipal system and any house
ar building for which the application is made,the owner or contractor shall be required to obtain a permit for such
conrrectian,and shai!pay a.permit fee as provided in Cha�ter 11 of this Code. After such connection has been
made,the Water and Sewer Department shah be notified. It shaff he un{awcful to covec any cannecting Gne until an
inspection has been made and such connection and the work incident thereto has 6een approved by the City as a
proper and suitable cannec�iun.
402.06.REPAIRS AND MAINTENANCE TO CONNECiION �
��.��p� • � --�-----�a^+ the water service curb stoo bflx or the sewec lead at the prapett'
{ine or a water servite or sewer lead has 6een extended to the property line for connecbon,the apptiant,owner,
or the occupant or user af such premises shall be liable for ail�epairs required to any water line and sewe�lines
necessary for connection of the premises ftom the main to the premises. tf the prop�tty owner�equests
maintenante service flr repairs 6e perfnrmed by the City,the property owner shall be charged for the��of the
. maintenance and/or repairs, including any necessary street repair�,at a rate set annua!!y by.an administrative
poticy. it shal{be the responsibil'�ty af the applicant�owner,occupant or user ta perf'orm standard maintenance af
• the sewer service line from the premises to the main including de6ris clearing or raot cutting and to maintain the
water service cur6 stap box for operability and at suth height as w11 ensure thet it remains abave the finished :
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•'°grade of�tiie�land ar�rop�t�ty.�(Re�63�,1�55,_t�n�:J .. . ._ � --
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