Meter Swap � *
• Request Number: 14978
Public Works Division
Service Request
Problem Address: 4624 2 1/2 St Requested By: RickNelson
Depxrtment: WA1ER Address: No address provided
Problem/Isaue: INSTAI,L AMR METER Phone Nnmber. 612-963-2487
Schedaled Date: 2017-05-01 Sc6eduled'llme: 09:00:00
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ACIION NEEDED: �
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Cres�ted by: B$th Kondrick Date Created: - - 2017-04-26
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ACIION TAI�N:
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5tatus: In Progress ��tter Ass Beee r
Con�tacted
Date Compieted: �+ � ,�� Completed by: r Q�� ,�
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City of Fridley S a � ���-
Water Departrnent
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what�necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and ali ir�terior
plumbing. (Per Ctty code 402.06) I also hoid the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb stop box and senrice line. In understand 1 am alw required
to obtain a permit prior to any work,i#necessary.
FINAL METER READING(old meterj ���� ��
Name: �4�V"" �" ``�v� Address t`v�� d� t'F' `�� •
Phone Number`�'`�" ���'�y�� pa� J � � r � �
Signature Witness Signature
OLD METER# V t�� I �✓v i
OLD READING �� r�" l�
NEW METER# ` 1 O`"���J �
NEW READING � ��`t.�'
ERT# � ` YO� ����
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 co�necting the existing municipal system and any house or lwiiding for which the
application is made,the owner or contractor shall 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 Department shall be notlfied. It shall be unlawful to cover
any connecting line until an inspection has been made and such connedion and the work incident thereto has been appro�d by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has beea 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 applicaM,owner,or occupar�t or user of such premises shaii be liabie fa�ail repairs
required to any water line a�d sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests maiMenance service or repairs be performed by the City,the property owner shall be charged for the casts of the mai�enance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. It shail be the responsibility�of the appiicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris ciearing 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)