Meter Swap �r ��` fi ,t
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city of Frialey
Water Det�ar_ tment
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Name �1�� �� �� ��
Date ! ��� l v
Old Meter Number 1�,�1 ���r�
Old Meter Readin 1� � �
Replacement No. ���� ' l��
Replacement Reading �
Replacement Make ����
Remarks• �bQ�C� ����-
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Request Number: 9681
Public Works Division
Service Request
Problem Address: 98 64th Way Requested By: Esther Crillespie
Department: WATER Address: No address provided
Probtem/Issue: INSTALL AMR METER Phone Number: 763-586-8119
SchedWed Date: 20 5-01-16 Scheduled Time: 11:30:00
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ACTION NEEDED:AMR
Createdby: WendyHiatt DateCreated: 2015-01-14
ACTION TAI�N:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
Hours
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� - C'ity of Fridley
- , _ .. Wat�rDppartm�nt -
. ... . _, .�- -
6431 Uni►rersity Avenue NE
Fridley,MN 55432
(763)572-3566
��yYe hereby authorize the�tY��dley and/or its
empluyees to do what is necessary ta replace tt�e water meter, i understand�at d�e PropenU owne�
�s tiabie far the water line from the main to the premise and all int�riar pium6ing. (Pei't�itjl code
402.06) i alsa haid the City of Frid�eY and/its employees harmlessfor any aamages�na�nwr�.•.���
while doing this operation. This ta indude,but nat limited to;val��►p�ping,walls,floars or the curb
stop box and service line. 1 understand I am also required to obt�n a percnit priorto any work,if
, necessary. � �
Final meter reading(old meter) J � ``'
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Name: Address• . :
Phone Number: Date' ` �I (�
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Signature:� �-"j!� ' ����
VNitness Signature:
FRIDLEY CITIf'CODE
CHAPTER 40L WATEIt,STORM WATER,AIVO SAIdiTARY 5EWER }
ADMINISTRATION �
(Ref Ord No 113,464,565,566,629,638,66Z,422,988,1144,1156,1191)
402.05.PERMIT FEE �
Prior to constivcting or repair af any water or sewer line connecting the existing municipal system and any house
or 6uilding for which the application is made,the owner or contractor shall be required to abtain a permit for such
wnnectian,and s6all pay a permit fee as provided in Chapte�li of this Code. After such connection has heen
made,the Water and Sewer Depa�tment shatl be notified. it shail be unlawful to cover any cunnecting line untii an
inspection has been made and such connection and the work incider�thereto has been approved by the City as a
proper and suitable connection.
402.06.REPAIRS AND MAIMfENANCE TO C�NNECTICIN
___� ,, ,.;.rha,�,atPr service cw�h stou bnx or the sewer lead at the propert�
-A#.ea'-tbe-iaitia
line or a water servtce or sewer lead has been extended to the praperty Ime for connechon,the appiicant�owner,
or the occupant or user of such premises shall be liable far all�epai�s required to any water line and sewer lines
necessary for connection of the prernises from the main t�thP operty owne�shall be d�arged for the cosks of the
maintenance service or repairs be perfarmed 6y the City,
malntenance and/or repairs, including any necessary street repairs,at a rate set annually by.an admin)strative
policy. It shall be the resporui6ii'dy of the appliant,owner,accupant o�user to perfarm standard maintenance of
the sewer service line from the premises to the main including debris ciearingor roat cutting and to maintain the
- water service cur6 stap box far operability and at such height as will ensure that it remalns abuve the flnished .
` ReF 635,-;.�.SS,.'1��3:� _. .. . .. . � . ... -
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