Meter Swap ___
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City of Fridley
Water De artment
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Name
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Date �`�^ �c.; 3
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Old Meter Number
Old Meter Reading
Replacement No. �- � �� � . '
Replacement Reading
Replacement Make �� �
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Request Number: 8069
Public Works Division
Service Request
Problem Address: 301 Rice Creek Terrace Requested By: Tony Austinson
Department: WATER Address: No address provided
Problemllssue: INSTALLAMR ME1�R Phone Number: 952-457-6534
Scheduled Date: 2014-06-13 Scheduled Time: 02:00:00
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ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created; 2014-06-12
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)572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to�eplace the water meter. I understand ihat the properly owner
is liable for the water 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 nat 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.
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Fina!meter reading(old meter) -
Name• Address• �� 1 �;1�'� ��Q� '�1��a�C/ 'k
Phone Number Date: — � l l� ���---
Signature•
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(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 appiication is made,the owner or contractor shall be required to obtain a permit for such
connection,and shalt 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 suitable connection.
402.06,REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service 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 ail repairs required to any water line and sewer lines
necessary for connection of the premises ftom 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 annualiy by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
° the sewer service line from the premises to the main including debris ctearing or root cutting ar►d 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)