Meter Swap Request Number: 8048
Public Works Division
Service Request
Problem Address: 580 67th Avie Requested By: Jeffrey Hoffman
Department: WATER Address: No address provided
Problemllssue: INSTALLAMR METER Phone Number: 763-423-7063
Scheduled Date: 201406-12 Scheduled 7ime: �9:OU:QU
ACTION NEEDED: 2014 AM (` �-G� � ^i�
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Created by: Wendy Hiatt Date Created: 201406-11
ACTION TAKEN:
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Status: In Progress Resident Contacted �
Date Completed: Compieted by:
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� � City of Fridtey
- Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
iJwe hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. 1 understand that the property owner
is liabie for the wate�line from the main to the premise and all interior plumbing. (Per City code
402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to include,but not limited to;valves,piping,walls,floors or the curb
stop box and service line. I understand i am also required to obtain a permit prior to any work,if
necessary.
Final mete�reading(old meter) ����I v
Name• Address:, ���/ ���4 �v�
Phone Number: Date: ��` �� � `
Signature• � ►
Witness Signatu •
FRIDLEY CITY CODE ,
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRAT{ON
(Ref Ord No 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 municipat system and any house
or buiiding for which the application is made,the owner or contractor 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. It 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
proper and suitab{e connection.
402.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property
line or a water secvice or sewer lead has been extended to the property line for connection,the applicant,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 prope�ty owner requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. tt shall be the responsibility of the applicant,owner,occupant or user to pe�form standard maintenance of
° the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)