Meter Swap ' Request Number: 15253
Public Works Division
Service Request
Problem Addresa: 4749 2nd St Requested By: Kris Runnakko
Depnrtmeut: WA1ER Address: No address provided
Problemllssue: INSTALL AMR ME1ER Phone Number: 651-503-4156
Scheduled Date: 2017-OS-11 Schedaled'Time: 11:00:00
� 7' I �
A�ON NEEDED:
Created by: Beth Kon�ick Date Created: 2017-OS-10
ACITON TAI�N:
_......._____._......_._____._. �S..�CC�'
Status: In Progress 5abmitter Has Been r,
Cout�ted
Date Co�pleted: � � � _�� Completed by: � ��
�
�
�`��;� ,. � �', "
K �
� Afa.._�:, : a �. ..
+ • /r �j��� ,� ✓
City of Fridley �� ( �•f� ✓
~ Water Department �2
6431 University Avenue NE C 6 �i �
Fridley,MN 55432 �
763-572-3566
I/we hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the rnain to the premise and all iriterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for amt damages that may occur while doing this
operation. This to include,but not limRed to valves,piping,walls,fioors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �� ���� D
Name: 1" 1 �� r��''�/Y�'\0�,��.v Address � ��' '
Phone Number Ca5 i— �03 - '�l�(� Date �✓� ✓ �� ""
+�
Signature Witness Signature
OLD METER# L����� V
OLD READING a 3� � ��c�
NEW METER# 1 I O10�� �3
NEW READING D
ERT# � � a �. � 3a3
FRIDLEY 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 arry water of sewer line wnnecting the existing municipal system and any house or building for which the
appiication is made,the owner or rnntractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shal!be unlawful to cover
any connecting line until an inspedion 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 serwice lead has
been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shall be liable for ali 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 shaii be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali 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 clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j
{� M
R ��� �` ? £�3x 'if $ ';y,r �.Yi h" F h� &r§
i' L"� �
�em $p_� '� c� e
. .�r K'�::e�p i.. �c:'j�
� .' .! � 1.iVV�� ' 7 I,.
Name
Date .�l�� �
Old Meter Number �'"' �`����
Old Meter Reading "�—" ��
Replacement No.�--�"r� `'��
Replacement Reading � ,__.---
Replacement Make
Q � , •+/ ,
Remarks: � P`�cP� ��,
Signe