Meter Swap �'' � Request Number: 14942
Public Works Division
Service Request
Problem Address: 4863 2 1/2 St Requested By: Robert
Department: WATER Address: No address provided
Problem/Issue: INSTALI.AMR METER Phone Number: ?63-234-8016
Scheduled Date: 20 7-Q4-26 Scheduied'Rme: OT30:00
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ACTTON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-04-25
ACTION TAI�N:
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� Status: In Progress Sabmittec Has Been r.
Contacted
Date Completed: Completed by:
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City of Fridley
Water Departrnent
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
I/we 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�vner is iiable for the water line from the main to the premise and all irKerior
plumbing. (Per City code 402.06) i also hold the City of Eridley andJits emp{oyees harmless for arry damages that may occur 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 afso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)_ 4 � lo`� `7 ��
Name: ��V�� Address ���� � i� I!1
Phone Number���'��� {-� !UV�� Date 1 � �� — 1�
Signature Witness Signature
OLD METER# _ �1 ��"!O��
OLD READ{NG � D �� � t O
NEW METER#_ l � (�U � � J�
NEW READING �
ERT# _� ��� � � � �
FRiDLEY CIT1f CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION , .
(Ref Ord No 113,464,5b5,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
P�ior to constructing or repair of any water aE sewer line connecting the existing municipal system and any house or building for whtch the
application is made,the owner or contractor shail be required to obtain a permit for such connection,and shall pay a permit fee as propided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shail be notified. tt shail be unfawful to wver
any wnnecting 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 MAINTENAP{CE TO COAINECTION
After the initial wnnectioa has bee�made to the water service curb stop box or the sewer lead at the property line or a water sen�ce kad has
been extended to the property line for connection,the applicant,owner,or occupant or user af such premises shafi be liabie for all repairs
required to any water line and sewer lines necessary for connectton of the premises from the main to the prernises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mai�enance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shali be the responsibility of the applicant,
owner,occuparn or user to perform standard maintenance of the sewer service line from the premises to the main including debrPs clearing 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 538,1156,1191)