Meter Swap ,,..r - � ,�
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Fritlley
Request Number: 172.7Q
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P�c Works Div�ion
Service Requeat
Pro�em�eas: 5770 2nd St I�equested By: Clni Chtii
Departme�t: WA'1ER Addre:s: No ad�'css provided
Problem/Issye: INSTAI,L AMR ME1ER Pho�Number: 612-250-9770
Sche�nled Dwte: 2017-I 1-21 Se6eduled Tlme: 09:00:00
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Crextedby: WendyHiatt llnteCreated: 2017-11-14
ACTION TAKEN:
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Status: In Progress Snbmitter A�Been r
Contxcted
Dxte Completed: Completed by:
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� City of Fridley
Water Department /
6431 University Avenue NE ( � � ��V���
Fridley,MN 55432
r 763-572-3566
I/we hereby authorize the City of Fridfey andjor its employees to do what is necessary to
replace the water meter. I understand that the properly owner is liable for the water line from the main to the premise and all inte�tor
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocair while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)
Name: � G�..� Address �7 7b �+� ��
Phone Number ���- as� 9?7� Date�__�i�.� ��
Signature Witness Signature
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OLD METER# i S R I 3 y s I sizE & STYLE(Ctrclel ,/ ,
OLD READING � a�� d0 �
3 5/8" HEX ,.Z�`� ��.
NEW METER# ��� �I 2 G'? 1" HEX
NEW READING � 1'r4" ELIPTICAL or � �.�.y�
ERT# 7��y� 7 s 7 2" ELIPTICAL or HEX
FRIDIEY 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)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipai system and any house or building for which the
appiication is made,the owner or coMrador shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to cover
a�y conneding 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 APID MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property 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 necessary street repairs at a rate set annually 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 induding debris clearing or
root cutting and to maintain the wate�service curb stop box for oqerability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,3156,1191)
Request Number: 10611
Public Works Division
Service Request
Problem Address: 5770 2nd 5t Requested By: � Chu Chu
Department: WATER Address: No address provided
Problem/Issue: WATER MAIN BREAK Phone Number: 612-250-9770
Scheduled Date: Scheduled Time:
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ACTION NEEDED:Water mainbreak Gopher ticket# 152$00867
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Created by: Wendy Hiatt Date Created: 2015-10-07
ACTION TAI�N:
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Status: InProgress ResidentContacted C3
Date Completed: Completed by:
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