Meter Swap � Request Number: 15352
Public Works Division
Service Request
Problem E4ddress: 4548 2nd St Requested Byc Mr Barta
Department: WA1ER Address: No address provided '~'���
Problem/Issue: INSTALL AMR METER P�one Number: 572-2285 � `:
SchednledDa 017-05 0 Schedulcd'Rme: 11:30:00
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ACTTON NEEDED:
Created by: Wendy Hiatt Date Cre�ed: 2U 17-OS-1 S
ACIION TAI�N:
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St�tus: In Progress Subm�tter Has Been r.
Contscted
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Date Completed: Completed by:
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' City of Fridley �O�-- (�(�3 C,. G�� �D c�
Water Department r�
6431 University Avenue NE � .1.� � !� �
Fridley,MN 55432 -��
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
place the water meter. I understand that the property owner is liable for the water line from the mein to the premise and all interior
'' lumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
' op�ion. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand i am also required
�` to obtalu�' a permit prior to any work,if necessary.
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FINAL METER REA NG(oid meter)� � `�
Nam �� •
Address
Phone Number ��"� Date � ' �/ ���
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Signature Witness Signature
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OLD METER# "
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OLD READING '�7�0� � �`� ,�-- -. '�
NEW METER# ���:i 'A�I --- .
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. 49225979 .
NEW READfNG . ___ ,
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1 1 72355'127 "
FRIDLEY CITY CODE
4�,� CHAPTER 402.WATER,STORM WATER AND SANtTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
- 402.5 PERMIT FEE
� �Y+rior to constructtng or repair of any water of sewer line connecting the existing municipal system and any house or building for which the
�q a�`'application is made,the owner or corrtractor shali be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. it shail be unlawfui to rnver
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 suitable connection.
���� 402.06 REPAIRS AND 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
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been extended to the property line for connection,the applicaM,owner,or occupant or user of such premises shall be liabie for ali repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff 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 annuaily 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 including debris ciearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wilf ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j
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� Request Number: 11594
Public Works Division
Service Request
Problem Address: 4548 2nd St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nuraber:
Scheduled Date: 2016-06-24 Schednled'lime:
ACITON NEEDED:Install AMIt
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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Status• In Progress Submitter Has Been C,
� Contacted
Date Completed: - Completed by:
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' - Ci�y�f Fridley
- _ � inlat�c Departenent _ _ _� ,� _
64�1 Univ�rsety Aven�ae N� -
fridley,fViN �5432
(753�572-356fi
lJwe hereby authorixe the City of fridiey andj€�r its
er�ployees to d€►wh�t'is ne�cess�e�t to�epiace the water me#er, (unde►�tartd that the prupert�(owner
_isliable_�'or the wat�r(ine from#he main to the premise and a���rior pir�mbing. (Per C�ty code
q02.t�6) I.ais+u fiold fihe Ci�y of Fridley and jit�emptoyees harmi�ss or any amages a tnay �-
while d�aing this operation. Tfiis to indude�bu�not Gmited to;�+a�es,piping,walls,floors or the cur6
�top bax and service line. I understand t am also required to aht�in a Fermit Priar tc�any wvrk,if
netessary,
. Fina(meter�eading�old meter� .
Name•
Address: y 5'-1 $ �`� ��
P6one Number: [ta#e:
St�i1�fl8P8:
IN�itli@SS S9�i1�1.7J['L:
�tiIDL�Y CCfY C�DE
�I�i#'TER 4��.WATEft,5'�'ORM WATER,l4�t0�14TAt�Y SEWER
A►Di�tIN1S5'RATlQt�
(Ref�rd�l01�.3r 464,555;56616Z9,fi�8,662,922,988,1�.44,1156,�.191}
40�,05.P'£RMIT FEE �
Frior to canstructing or repair�T any water flr sewes IinE cc�nnecti�rgthe�s�ing�nunicipal sys�em and any hnuse
or 6uild'tng for which�tfte appCcation is made,the awner or cor►fractar shatl be requ+red to obtain a permi�for such
ta
canrrectianr and s6ali pay a Perm�t fee as P�°"'�ed in Chapte�11 afthis Code. After such cnnnec�ian 6as been
made,the Water and Sewer Departmeat shail be natified. it shail6e untawful to cauer any r.onne�ting fine until an
inspec�ion has 6een made and such�anner.tion and t6e work incident theceta has been�pproved by the Caty as a
proper and s�°ttable co�srtect9on.
4l�2.06.i�EP�,IR5 A�i�►M�,INTENAs110E i'0�Oi��tEC�'It7.N
-A�-�r-���..iai�i,au . • __�____ ,as+n tM�water service cur6 stoa b�x 4r the s�wer[ead at the prape��
line or a water service or sewer iead has heen extended to the propertyline#or cannechon,#he appticant,owner,
or the accvpant qr user af such premises shall be ii�ble fdr all repei�required t�am/water line 2nd sewer lines
necessary for cQnnectian of the prernises from the main ta the pr�nises, lf the ptape[iy awner requests
mainfienance service ar repairs be perfnrmed by ihe Ctty,�the property owner shaif be charged for�he eo�ts of the
_ maintenance and/or repairs, includinganV rieces�arY s�re�t repair�at a rate set annual(y 6Y.an admitiwtrative
po(icy. It shall be the respbnsi6iiitY ofthe applicants owner,occupantor user ta pe�Form s��ndard maintenance of
• the sawer service line from fhe Premises te the main inc�uding debris clearing nr raot cutting and Co melntairi the
water servic�cur6 s�np hox for operability and afi suth height as will ensure fihat i�remains abave the finished i
=:'gra"ci"e of�.i��land or-pr���i.y.�¢R�63�,�.��,-��`��� -- ._ _ ._._ ._.- � .. _ .:.._ .�.� . --=. .:. � ..._..