Meter Swap Request Number: 8087
Public Works Division
Service Request
Problem�kldress: 380 Rice Creek Terraace Requested By: Beverly Gallarane
Department: WA"fER Address: No address provided
Problem/Issue: INSTALLAMR METER Phone Number: 571-9228
Scheduled Date: 2014 -1F Scheduled Time: 01:00:00
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ACTION NEEDED: 2014 AMR .
Created by: Wendy Hiatt Date Created: 201406-13
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Compkted by:
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- City of Fridley
Water Department
6431 Univer5ity 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 repiace the water meter. 1 understand that the property owner
is liable for the water line fram the main to the premise and all interior ptumbi�g. (Per City wde
402.06) I a{so fiold tfie City of Fridley and/its err�p{oyees harmless for any damages that may occur
whife doing this operation. 7his to inc{ude,but not limited to;valves,piping,wal{s,floars or the curb
stop box and service line. I understand i am atso required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) ��v ���O
Name• Address•, �Vo �« C r�' �� �
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Phone Number: Date: D'"�� �—
Signature• �
Witness Signature:
FRIDLEY CITIf 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 application is made,the owner or contracto�shall be required to obtain a permit for such
connection,and shaf{pay a permit fee as provided in Chapter 11 of this Code. Afte�such cortnection 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 CONNEC170N
After the initiai connection has been made to the water service cu�b stop box ar the sewer lead at the property
line or a water senrice or sewer lead has been extended to the property line for connectian,the applicant,owner,
or the occupant or user of such premises shalf be tiabte for afl repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the propetty owner requests
maintenance service or repairs be performed by the City,the property owner shatl be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrattve
policy. It shall be the responsibifity of the applicant,owner,occupant or usec to perform standard mainte�ance of
- the sewer service tine from the premises to tfie main including debris clearing ar roat cutting and to maintain the
water service curb stop box for operabi{ity and at such height as will ensure that it remains above the finished
grade of the tand or property. (Ref 638,1155,1191)