Meter Swap • Request fc�r Service R�por#
_ City af Fndley
Re�eren+�No: fi0�-12-A�IQ Dat�: 119/2Q12
Request T�r�re: TY�s+envioe� Enk�ed By. Wendy�att
�p�trr�errtt: Sev� t.�iz�i+��ne: Mary t�v�ei
Ad�� 375 S6TH AME NE adc�: 763-�71-c�227
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Request Number: 7983
Public Works Division
Service Request
Problem Address: 375 66th Ave Requested By: Mary Ann Lumieski
Depa�tment: WATER Address: No address provided
Problem/Issue: INSTALLAMR METER Phone Number: 571-2227
Sched led Date: 201406-05 eduled Time: 01;00:00
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ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 201406-04
ACTION TAKEN:
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Status: In Progress Resident Contacted �
Date Completed: Completed by:
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. � . City of Fridley
� Water Department
6431 University Avenue NE
-� Fridley,MN 55432
(763)572-35b6
I(we hereby authorize the�ty of�ridtey and/or its oWner
employees to do what is necessary to replace the water meter. 1 understand that the prope�e
is tiabie for the water line trom the main to the p�emise a a����Q°any dam ges that may occur
40z.Ofi) i aiso hatd the�ty of Fridiey and/its empioYees h � i� ���5�{�oors or the curb
while daing this operetion. This to include,hut not limited to;valves,p'p g. .
stap box and service line. 1 understand 1 am alsv required to obtain a permit prior ta any wark,if
necessary. � � � �
d meter �
Final rneter reading(ot ) -��
Address:_[J��� "
Name• �� •
M� � ���
Phone Number• Date: �
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Signature• _,.
Witness Signature:
FRIDLEY GTY CODE
CHARTER 402•WATER,STORM WATER,NND SAWiTARY SEWER
ADMINISCRAT1aN �
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.05.PERMIT FEE �
Prior to constructing or repair af any water or sewer line cannecting the existing municipal system and any house .
or building for which the application is made,the owner or cuntractor shatl6e required to obtain a permit for such
connectinn,and shall pay a�ermit fee as provided in Chapter 11 of this Code. After such connection has been
made,the Watec and Sewer Department shall be no�h�ork ncident there o�has been pp oved by the City as an
inspectian has been made and such cannection and .
proper and suitable cannection.
402.06.REPAIRS AND MAINTENANCE TD CONNECTf�N
After the initial connection has been made to the water service curb s�aP be forf connection`the ap cantPuwner,
line or a water service or sewer lead has been extended to the property hn
or the occupant or user of such premises shail be liable for atl repairs required to any�to�ner requests r��nes
necessary for connection of the premises fram the main to the pcemiseo��ne sha41 be charged for the casts of the
maintenance service or repairs be performed by the�tY,the property
mainte�ance and/ar�epai�s, including any necesSa�V st�eet o�Pu rant or ser to perfo m standard"mainte a ce af
po{icy. It shafl be the responsibility of the applicant,owne , p
• the sewer servrce line from the premises to the main includi�ad�'�en'sure hat t r mains ab ve the fi ished he
water service curb stap box for operability and at such heigh
grade of the land or praperty. (Ref 638,1156,1191)