Meter Swap 4 � Request Number: 15023
Public Works Division
Service Request
Problem Address: 4610 2 112 St Requested By: Vanessa 1l�mpson
DepArtment: WATER Address: No address provided
ProMem/Issue: INSTAI.L AMR METER Pho�Nu�nber: 651-354-6562
5chedeled Date: 2017-OS-04 Sc6ednled 1lme: 02:00:00
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 201?-O�t-28
ON TAI�N:
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._..__.___._..._..._._._____.. __._._.______._.__ ._.______._.. ___..� �r
StAtus: 1n Progress Sabmitter Has Been r,
Coat�ted
Date Compltted: Completed by:
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City of Fridley l�� ' ��(,�-��� y��
Water Department �
6431 UniversityAvenue NE ��� 2���j
Fridley,MN 55432 '�
763-572-3566
UWe hereby authorize the City af Fridley and/or its employces to do what is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all iriteerior
plumbing. (Per City code 402.06) I aiso hold the City of Fridley and�ts 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 arb stop box and servi�line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) '"� `�J � �J���
Name: Y '�V�aiddress �� "`� � �/2— �
Phone Number Y��I��7V Yr O��e�` `� `� `�
Signature ` Witness Signature ���
OLD METER#_, � ���� ��
OLD READING � � �� � V
NEW METER# ���O � � ��
NEW READING �
ERT# L I �U� i����
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 municipai system and arry house or building for which�e
application is made,the owner or coMractor shall be required to obtain a permit for wch connection,and shall pay a permR fee�provided in
Chapter li of this Code. After wch connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Citq as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the properly IQne or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable 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
reques#s maintenance service or repairs be periormed by the City,the property owner shall 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 applicaM,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main indudir�debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wtll enwre that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)