Meter Swap � � Request Number: 15467
Public Works Division
Service Request
Problem Address: 4632 2 1,2 St Requested By: Kevin Larson
Department: WA1ER Address: No address provided
Problem/Isaue: INSTALL AMR METER Phone Number: 952-388-8237
Scheduled e: 2017-OS-25 � Sc6eduled 13me: i}9:00:00
ACTION NEEDED:
Created by: Wendy Hiatt Dste Created: 2017-OS-19
AC'IION TAI�N•
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5tatus: In Progress Submitter Has Been r,
ContActed
Date Completed: Completed by:
S-2S- (� -T-'�lor
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� City of Fridley l Q( � ����1� 'D�
,� Water Departrnent
6431 University Avenue NE 5a� ��3�
Fridley,MN 55432
763-572-3566
���^'e hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the matn to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City of Fridtey and/its employees harmiess for arry 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 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter) '�����
Name: K�-�✓v,X� ����Y ` Address "'1��� �,�'L ✓�
Phone Num6 � ���Y� y�� Date ��J�� l.�
Signatur ' ess Signature
.....�_
OLD METER# ���� �� f J
OLD READING `,�� v' V � S�Y�O(iU J7�`� 1 u``�► ��,p�1� a't" �'�-
".1`'�
NEW METER# `=L T��i 1� 'W� C�
NEW READING y.J
ERT#_� I/�����
FR(DLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
4Q2.5 PERMfT FEE
Prior to constructing or repair of any water of sewer line wnnecting the existing municipal system and any house or lwilding for which the
application is made,the owner or contrador shall be required to obtain a permit for sucfi connection,and shali pay a permit iee as provided in
� Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shail be notified. It shall be unlawful to cover
any connecting line urrtil an inspection has been made and such connection and the work incident thereto has been approved by the�ty as a
proper and witable wnnection.
402.�6 REPAtRS AP(D MAINTENANCE TO COINNECTION
After the initial connedion has been made to the water service curb stop boz or the sewer lead at the properly line or a water serviae lead has
been extended to the property line for connedion,the applica�,owner,o�oaupant or user of such psemises sha11 be liable for aif 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 wsts of tt�e maintenance and/or
repairs,inc{uding necessary str�ee�t 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 mairrtenance of the sewer senrice line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop 6ox 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)