Meter Swap r
• Request Number: 14956
Public Works Division
Service Request
Problem Address: 45 t 2 2nd St Requested By: Jim Jackson
DEpartment: WA'IER Address: No address�ovided
ProMem/Lsaue: INSTALL AMR ME1ER Phone Number: 612-201-1906
Scheduied Date: 2017-05-05 Schedaied 1Yme: 10:30:00
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ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-25
ACIZON TAi�N:
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Status: In Progress 5abmitter Haa Been r
Co�acted
Date Completed: l' G��� Completed by: ���
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City of Fridley � � �
Water Department S
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridiey 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 ir�teerior
piumbing. (Per City code 402.06j i also hold the City of Fridley andrts employees harmless for any damages that may oaur while dang this
operation. This to include,but not limited to valves,piping,walls,floors or the carb 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 ��V
Name: �l W1 d(,�.(,��iY1 Address_ �✓�� �L7A� �
Phone Number ��2— °`'��~ I�V lV Date �` � � � l
Signature Witr�ess Signature
OLD METER# �� 1 �"`'`�' ✓�J
OLD READING 3 �'g��a
NEW METER# ������ _J
NEW READING �
ERT# �` � II �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATION
(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 connecting the existing municipal system and any house or buitding for whkh the
application is made,the awner or corrtractor shall be required to obtain a permit for such connection,and shail pay a permit fee as prorided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawfui to cover
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 initiat connection has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead fias
been entended to the property line for connection,the applicant,owner,or occupar�t or user of wch premises shall be liable for all repairs
required to any water tine and sewer lines necessary for connection of the premises from the mai�to the premises. If the property a�rner
requests maintenance service or repairs be pe�formed by the C'ity,the property owner shall be charged for the c�ts of the mair�tenance and/or
repairs,including necessary street repairs at a rete set annually by an administrative policy. It shall be the responsibility of the applicar�t,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main induding debr�deartng 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)
w
v Request Number: 11601
Public Works Division
Service Request
Problem Address: 4512 2nd St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
Scheduled Date: 2016-06-24 Scheduled TSme:
ACTTON NEEDED:
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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Status: In Progress Submitter Has Been �
Contacted
Date Completed: Completed by:
��i�
, ' - �i�yy�#Fridley
- . . __� Vsla�Pr�epa�ttment _ . :. . �.�_
64�1 Universi�y Avenu€NE
Frid(ey,Mf� 55432
(753j 572-3566
df.we hereby auth�rixe the City of Fridiey andjor its
empioye+es#o do what�s necessary to replace the water meter.[understand that the praperty owner
_i�tlabl�f�r the water Iine from the main to the�rem3se and all a�riar piumhing. {Per City cade
q02,�16) i.al��hold the�iiy of Fr3dley a�nd/its employees harn�(�S '��any amages a may �'
wh�e daing t�his aperadvn. This tv indude,hut not timited to;ua�res,P�Ptng•�•floors or the crarrb
stap 6ax and�ervice line. I anderstand t am aLso requir�d to qhtain a permit priar to any woti�if
necessary,
�inal meter�eading told meterp .
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Name� Address:
Rhone Number• Da#e:
Sigttai�are:
UU"rkttess 5ignature:
�HiDtEY CtTY C�DE
CHE[PTER�tlZ.WAT��t,Sf�EtM W�►TER,ANa�ANCTARY SEWER
�DMINISTRATI�H
LRef CJrd No 113,464,565;566,��9,G38,662,92�,988,1�.44,1156,1191]
4t��.05.PERMIT FEE �
Prior to canstructing csr repair of any water nr sewer line connectingthe existing rnunicipai sys�em and any house
ar building for which the application is made,the awner Qr cff�ckar shall be required ta obtain a petmi�for such
canrrectiani and shalt pay a perm�fiee as pravided in Ci�apter 11 ofthis Code. After such cnnnection bas been
made,the Vllater and Sewer Department�ha�1 be nati#ied• 1t$ha(I 6e unlawful to caver any eonnecting Gne unfi)an
inspection has heen made and such connection and the work incidet�thereta has heen app�aved by the Gty as a
proper and s�'ttable connectian.
402,08.REP�IRS APim MAiNTENANCE TQ�ON�IECT(QN
��,����p� . �___�_„�_...aa+R��water service curhstaa bax nr the sewer(ead at#he prapert'
line nc a water service or sawer(ead has heen extended tn the p�Dper�yline for cannechon,the appticant,owner,
or the occupant qr user af such gremises shall be liabie for eli repak�required to arry waker iine and sewer line5
neces5ary far connection of the premises from the main t°�e Premises. If the propeCky owner requests
rnainfier�ance senrice ar repairs he perfnrmed hy fhe C►ty,�the prapetty awner�hall be tt►arged for the�osts of the
. maintenance and/ar repairs, inc(uding any neces�ary street repairs,at a rate s�t annuai(y by.an admin�tra�ve
policy. !t shall be the responsi6ility nfthe aPPli�antl uwner,occupantor user tn perform standard main#enance of
� the sewer service rne fram the premises ta the main inciuding dehri�clearing flr raot cutting and to mairitaia the
u+tater servic��cur6 st�p box for operability and at such heiglit as�Il ensure that it remains a6ave the finished
_.,gra�e of ti��tard ar�r��riy.��R�6 0,��5,_�,�9�:� _. ._ _ .__ ...- � . _ .:.._ .-� . .._. .:..� �-�-