Meter Swap � .�� s�'' ' ;t:r'Y`�� 't
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Old Meter Number � q�l��
Old Meter Reading �{�( � ��v
Replacement No. ��r��s�y ���'"""� �
Replacement Reading v
Replacement Make
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Replacement ERT#
Remarks: /�-•�^
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Request Number: 7058
Public Works Division
Service Request
Problem Address: 6520 Able St Requested By: Deanna Roth
Department: WATER Address: No address provided
Problem/Issue: INSTALL METER(WATER) Phone Number: 763-432-2681
Scheduled Date: 2013-09-2T Scheduled Time: 01:00:00
t c�..� � �
ACTION NEEDED: 2013 AMR
Created by: Wendy Hiatt Date Created: 2013-09-26
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
(7fi3)572-3566
I/we hereby authorize the City of Fridley and/or its
employees ta do what is necessary to replace the water meter. n�e do�t�m�ng.t(PerC'rly todeWner
is liable for the water line from the main to the premise and ail i P
402.06) I also hold the City of Fridley and/its emp���i�ited to;'valves,piping,wal�s.floors or the curb
while doing this operation. This to include,but n
stop box and service line. I understand I am also required to obtain a permit prior to any work,if
necessary. �
F(nal meter reading(old meter� � �-
Name• Address•
�,�� ��1� _
. Date: `��� r
� Phone Number
�� �
Signature•_ —��- -
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402•WATER,STORM WATER,AND SANITARY SEWER
ADMiN15TRAT�ON
(Ref Ord No 113,464,565,566,629,638,662,922.988,1144,1156,119-1� __
402.05. PERMIT fEE
Prior to constructing or repair of any water ar sewer line connecting ths�ell be equ ed to,b ain a pe m'�t for such
or building for which the application is made,the owner or contracto
connection,and shall pay a permit fee as provided in Chapter 11 of this Cade. After such connection has been
made,the 1Nater and Sewer Department shali be notified. It shall be unla fwEu�has been app oved by he City as'an
inspection has been made and such connection and the work incident the
proper and suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECI'ION
After the initial connection has been made to the water service curb stop'ne forrconnection�the app cant owner,
11ne 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�r��e aedUes�ts�r lines
necessary for connection of the premises fram the main to the premis o��ne 5hall be charged for he cost�of the
maintenance service or repairs be performed by the City,the propeRY
maintenance and/or repairs, inctuding any necessary str�eet o PU�rant or user to perfo m standard ma ntenance of
policy. it shall be the responsibiGty of the applicant,aw , P
• the sewer service line from the premises to the main in�e dn ad witl ensure t at it emains abo e the fin shed he
water service curb stop box for operahility and at such g
grade of the land or property (Ref 638,1156,1191)