Meter Swap ,, � Request Number: 14764
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Public Works Division
Service Request
Problem Address: 4720 2 1/2 St Requested By: Anthony
Department: WATER Address: No address provi�d
Problemllssue: INSTALL AMR METER Phone Number: 612-490-6502
Scheduled t 2017-04-19 ,� Schednled T3me: 07:30:Q0
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ACITON NEEDED:
Created by: Wendy Hiatt Date Crested: 2017-04-18 •
ACIiON TAKEN:
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��` Snbmitter Has Been
Status: In Progress CoMacted r
Ds►te Completed: �_ ✓ � Completed by: ����
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' � City of Fridley tj� �
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Water Department
6431 University Avenue NE
Fridley,MN 55432
763-5723566
f/we fiereby authorize the Ctty 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 liae from the main to the premise and ail lnterior
piumbing. (Per City code 402.06) I also hold the City of Fridley and/its empioyees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,fioors or the curb stop box and service line. in understand I am aiso required
to obtain a permit prior to any wcrk,if necessary.
fINAI Mf1'ER REAUING oid meter � �� � ✓ ` v
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Name• �+�Y`�_� Address �,�� r�C. ,l� ✓� '
Phone Number `-�'�� � l V � W �4� Date - !^ 1 t � � �
Signature Witness 5lgnature
OLD METER# � ��J ��/VV l(J
OLD READlNG ��� ! � L v
NEW METER#�o�V � V� v
NEW READING �
ERT# t �� ) tV � , 1
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 wnstructing o�repair of any water of sewer line connecting the existing municipal system and arry house or building for which the
application is made,the owner or contractor shalf be required ta obtain a permit for such connection,and shafl pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Wate�and Sewer Department shail 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 Gty as s
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of suth premises shall be liable for al!repairs
required to any water line antl sewer lines necessary for connectio�of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the properLy owner shall be charged for the tosts of the maiMenance and/or
repairs,including necessary street repairs at a�ate set annually by an administrative policy. ft shalf be the responsibility of the appli�nt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wifl ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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t�1d��tt�r I�T�'lb�r ' `
Old NTeter Reading_ ��� 9,�
Replacement No. � � �� �✓�
Replacernent Reading
Replacement Make__i��'�'
ERT#
Replacement ERT# _
Remaxks: C�� M�8^� �`'��
_ Signed -- �'
R�quest for Set�etce R�por�
City of Fri�i1��
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Ref�erenc�N�: �L a���� - `{�l � �at�: -- S"
Rcqu�ext Type: �1�C 6--�"��rY�. i°� Entered 8y.
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Dep�rkment: Citizen Name�
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Sahed�ed Qate: Property 4wner:
Locakion Detais: Raquest Qetails: �
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