Meter Swap Request Number: 9374
Public Works Division
Service Request
Problem Address: 1120 Gardena Ave Requested By: Diane Macken
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-572-8302
Scheduled Date: 2014-11-OS Scheduled Time: 11:00:00
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ACTION NEEDED:Install AMR
Greated by: Julie Horak Date Created: 2014-11-04
ACTTON TAI�N:
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Status: 1n Progress Resident Contacted ❑
Date Completed: Completed by:
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� - City of Fridley
- _� . iNatPr Departm�nfi
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6431 University Avenue NE
Fridley,MN 55432
(763)57Z-3566
1/we hereby authorixe the�tU��dley and/or its
employees to do what is necessary to replace the water meter. I understand that the property owner
er line from the main to the prernise and all interior plumbing. (Per C'ity cade
402.06j I aisa hald the Gty of Fridley andrt�empioyees harmless or any amages a may
white doing this operation. 'f'fiis tu 9nclude,but nat limited to;vaWes►Piping,walls,floors or the curb
stop box and service line. I understand i arn also required to obt�n a Permit Prior i�any work,ff
neaessary.
Ftnal meter reading(old meter) ��0� `�0 —
Name:
Address: ��;'��'�.J,e.�n o� l�.
Rhone Number. Uate:, t�'S lb �y
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Signature:, .y,
Witness Signature: �
FRID4EY CITV CODE
CHAPTER 402.WATER,STdRM WATER,AND SANITAitY SEWER
AQMINISTRATIQN
(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 municipal system and any house
or building for which the application is made,the owner or contraeto�shatl be required to obtain a permit for such
connection,and shall pay a permit fee as pruvided in Chapter 11 of this Code. After such connettian has been
made,the Water and Sewer Depa�trt►ent shal{be notitied. It shatl be unlawfui to caver any cannecting line until an
inspection has been made and such connecCion and the work incident thereto has been approved by the City as a
proper and suitable connection:
402.Ofi.REPAIRS AND MAfNTENANCE TO Cfl�INECTttIN
���p�� �____...,.,+�,�,a.uatPr service curh stap box oc the sewer lead at the propert"
line or a water service or sewer lead has been extended to the propertylme for connection,the appticant�owner,
or the occupant or user of such premises shalf be tiabte for all�epairs reqaired to any water line and sewe�lines
necessary for connection of the prernises from the main to the premises. If the prop�tty owner requests
maintenance service or repairs be performed hY the City,Che property uwner shall be t�arged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by.an administrative
paticy. It shall be the responsibil'rry of the applicant,awner,occupant�user ta perform standard maintenance af
� the sewer service(ine from the premises to the main including debris clearingar root cutting and to maintain the
- . __ . .. .. ..._..,....._ ._
water 5ervice curb�top box for operability and at such height as wiU ensure that it remains above the finishe
. � � .. . .. . . . .
""grade of tf7e lar�d or�rdperiy.-iReF 63�,Z��,-t���:) _. . ._.._ _.... ._. _._. ..... ..._..