Meter Swap �
� Request Number: 15022
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Pubtic Works Division
}�'��� Service Request
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Problem Addr�sa: �9'2 1/2 St Requested By: Miehelle V�holdt
Department: WATER Ad�ress: No adcfress provided
ProW em/Issne: INSTALL AMR METER Plaae N�cmber: 612-345-1 S 11
Schednled D�te: 2017-OS-OS Sched�led 73me: 07:30:00
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ACTION NEEDED:
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£rented by: We�y Hi�t Date Created: 2017-04-28
ACITON T�4KEN: �
`�S���eG ����------
Status: InProgress S�bmitter Has Beee r,
Cont�ted
I�te Completed: � (� _ I`—� Completed by: ` �
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� So-� ��3�
„ City of Fridtey
Water Department
6431 University Avenue NE
Fridtey,MN 55432
763-572-3566
��We hereby authorize the City of Fridley andJor 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 al!irtterior
ptumbing. (Per Crty code 402.06) I also hold the City of Fridiey and/its employees harmless for any damages that may��while doing this
operation. This to include,but not limited to vaives,piping,walis,floors or the curb stop box and service line. In understand!am also required
to obtain a permit prior to any wor�c,if necessary.
FIfYAI METER READING(old meter) ��� �� �
Name: ,"`d�� 4 K� V� V Addre��� � � 1 1�.. 5� •
Phone Number ��Z-� J { 'J�' �5�� Date �' �J"� � l
.�—
Signature Witness Signature
OLD METER# I � � O
OLD READING��� �/�-J
NEW METER# _ � t/ I U ` ( � �
NEW READING v
ERT# �� � ���� 1
FRIDLEY CITY CODE
CHAPTER 402.WA7ER,STORM WATER AND SANITARY SEWER
ADMINiSTRA710N
{Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
4fl2.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,tfie owner or corrtractor shail be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of tfiis Code. After such connection has been made,the Water and Sewer DepartmeM shall be not�ed. It shall be unlaarful to cover
any connecting line urrtii an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AAID MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer tead at the property line or a water senrice lead has
been extended to the property fine for connection,the appiiwM,owner,or occupant or user of such premises shall be liable for all repairs
requiret!ta any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property�rner
requests mairrte�ance service ar repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance and/or
repairs,includ'+ng necessary street repairs at a rete set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant o�user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to mairrtain 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)
i