Meter Swap FROM :CITY OF FRILlLEY FAX N0. :76�5711287 Sep. 30 2@13 10:16f�1 P1
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Requ�st Number: 7072
Fhut�i�c IIVor�cs Division
Service R�equ�st
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�r�oa�„a�a�: $a� �►a�. ►� R �ted �a,�, ..._____._...�.. ...
Dep�rtrh9tlt: WATER l�ddrese�: No adr�+e�provided
ProblenNlssue: INSTAt,�.AMF2 ARET'ER(WAIERj �hone NuA�ber: 783�571-0�3
Schee�ukNd Dute: �U13-10-01 Schedukd'tAme: 02:00:4t?
AC7'tip►N NEEp�D:
Created by: Jea�ie 8ensan data Created: 2013-09-30
ACTiQN TAlC�N:
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NEW METER REAAII3t�:
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Status: In Pr�es.s Resldent CQr�ta�ct�ed l�
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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 Fridiey andJur its o�er
empioyees to do what is necessary to replace the water meter. 1 understand that thP prape�e
is liable for the water line from the main to the premise and all interior plumbing. ( �Y
� 402.06j 1 also hold the City of Fridley and/its e�nP�o'�rt a o'valves,pip ng,waalis,floors o the�urb
while doing th�s operation. This to include,hut not
stop box and service line. f understand 1 am also required to obtain a permit prior ta any work,if
necessary. �� ���
Final meter reading(old meter) � �
Name: Address:
��l- �"���= -
Phone Number•
Date: �' �
Signature:
��� rn
Witness Signature:
FRIDLEY CITY CQDE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMIN(STRATI4N
(Ref Ord No 113,464,565,566,629,638,662,922.988,1144,1156,1191) _
402.05.PERMIT FEE
Prior to constn.icting or repair of any water or sewer line connectinBo shall ben equ redto'b ain a permit for such
or buiiding for which the application is made,the owner or contract
connection,and shali pay a permit fee as provibe not f ed. It shali be unlawful to cover any c nne'cti g li eeuntil an
made,the Water and Sewer Department shall
inspection has been made and such connection and the work incident thereto has been approved by the City as a
propec and suitable connedion.
402.06.REPAIRS AND MAlNTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop'ne forrconneet'on�the appl'icant owner,
line or a water service or sewer lead has been extended to the property �
or the occupant or user of such premises shall be liable for all repairs required to any wate��ner re uests r��nes
necessary for connection of the premises from the main to the premise�s��ner shall be harged for he costs of the
maintenance service or repairs be performed by the City,the proPerly
maintenance and/or repairs, including any necessary wner o cupant or ser to perfo m�tandard ma ntenaince of
policy. It shall be the responsibility of the appticant,o .
• the sewer service line from the premises to the main including debris ciearingor root cutting and to maintain the
water service curh stop box for operahility and at such height as will ensure that it remains above�he finished /'
grade of the land or property. (Ref 638,1156,1191) �
;