Meter Swap � Request Number: 15126
Pubjic Works Division
Service Request
Problem Address: 4620 2nd St Requested By: Karen
Department: WA1ER Address: No address provided
ProblemJIssue: INSTALL AMR METER Phone Nember: '763-227-4954
Scheduled Date: 201?-OS-08 5cheduied'Rme: 10:30:00
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ACITON NEEDED:
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Created by: Beth Kondrick Date Cre�ed: 2017-OS-03 ";_;,�,,
ACTION TAI�N:
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Sabmitter H�Been * ��
Status: In Prog�ress Contacted �
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Date Completed: � �_,`'7 Completedby: ���
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' City of Fridley SD'� 'r L��
Water Department ��
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the City of Pridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may oaur 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) " � v " �D
Name: �'��� Address "`� � '
Phone Number ��� ^���` ! / �� Date �� v � ��
Signature Witness Signature
OLD METER# ���� � �+✓
OLD READING ����C� � �-� ����`I I d� �'��� O��
NEW METER# `����S��
NEW READING �
ERT# � � 1��0''" �
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 any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connectYon,and shall pay a pervnit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any 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 suitabie 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 servke lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premtses shall be liabte 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 properly owner shall be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. 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 dearing 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 638,1156,1191)