Meter Swap Request Number: 9240 �
Public Works Division
Service Request
_._ .Problem Address:_ 1558 Briardale Rd RequestedBy: Dolores Varichak
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 572-1206
SchedWed Date: 2014-10-28 `� 5cheduled Time: 10:00:00
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ACTION NEEDED:2014 AMR
Created by: Wendy Hiatt Date Created: 2014-10-21
ACTION TAI�N:
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Status: tn Progress Resident Contacted ❑
Date Completed: Comp ted b :
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- City of Fridley
- ._ _ , WatprDepartment
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6431 Uni�ersity Avenue NE
�ridley,MN 55432
(763)572-3566
i/we hereby authorize the tity of Fridiey and/or its
emp(oyees to do what is r�ecessary ta replace tt�e water meter, i understand that the propert�►owner ,
ic liab�l fa the water line from the main ta the premise and all interior plumbing. (Per Gty code
402.06) I alsa hold the C.�ty of Fridley and/ii�employees harmless or any amages � a may�r-
while doing this operation. This to include,but nat limited to;valves,piqing,walls,floors or the curb
stop bax and service line. I understand 1 am also required to abtain a permit prior to any work,if
necessary.
Final meter reading{ald meter) � � " v�
Name:
Address: i��� �
Phone Number: /�'��/l
Signature: ^�r�
Witness Signature:
FRIDLEIf GTY CODE
R 402.WA?ER,STORM WATER,A(dD SANITARY SEWER
ADMINtSTRATIUN
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.05.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the applicatian is made,the owner or contractor shall be required to obtain a permit for such
connection,and shaA 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 shal)be unlawfu)to cover any connecting Iine unfil an
inspection has been made and such connectian and the work incident thereto has been approved by the Ciry as a
proper and suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNEtTION
���b�p�������,��.��+�*tio warPr service curh stop bnx or the sewer lead at the propert�
line or a water service ar sewer lead has been extended to the prupertyline for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all�epair5 required to any water line and sewer lines
necessary for connection af the premises ftom the main ta the preroises. !f the propetiy owner requests
maintenance service or repairs be performed by the City,the properly awner shall be charged for the cnsts of the
maintenance and/or repairs, including any necessary street repairs,at a rate 5et annually by.an administrative
policy. It shall be the responsi6il'rty of the applicant,owner,occupant or user ta perform standard maintenance af
• the sewer service line from the premises to the main including debris ciearingor root cutting and to maintain the
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water 5ervice curb stop box for operabil"�ijr and at such height as will ensure that it remains above the finished
graife of�tfi�iard orprcrp�r�y.�(ftef 63S,1L5,-t�n3:� ._. .� . . . . .