Meter Swap Y
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Request Number: 15351
Public works Division
Service Request
Problem Address: 4768 3rd St Requested By: Jeremy Jolmson
Department: WA1ER Address: No address p�ovided
Problem/�ssuc: INSTALL AMR METER �hone Nwnber: 763-439-9171
Scheduled D�tte: 2017-OS-16 .�.� Scheduled'Ijme: 11:30:00
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ACITON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-OS-1 S
ACTION T .
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Status: 1n Prog,ress Submitter Has Been r,
Coutacted
Date Completed: Completed by:
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CityofFridley j�� /��� ^� a ��
Water Departrnent ✓ ��� G �� �
6431 University Avenue NE `y"�' �'��
Fridley,MN 55432
763-572-3566
IJwe hereby authorize the City of Fridley and/or 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 mai�to the premise and all iMerior
p{umbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may ocaar while doing this
operation. This to include,but not limited to valves,qiping,walls,floors or the curb stop box and service line. In unden�tand 1 am also required
to obtain a permit prior to any work,if necessary.
FIPIAL METER READING(old meter) I� `����
Name: u�C�� A�►V ' V,VO Address __ i�� v �r� �
Phone Number + � � Date �^ � �� ��
Signature Witness Signature �
OLD METER# �� 1 ��`�
OLD READING ��Vc� �W
NEW METER# � O- I d ` I ��
NEW READING �
ERT# � � � I � �v��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,562,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to wnstructing or repair of any water of sewer line connecting the existing municipal system and arry house or buHdit�for which the
application is made,the owner or contrador 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 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 Crty as a
proper and suitable 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 pro�rty line or a water servke lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liabie 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 p►roperty owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the mai�rtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main including debris 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 638,1156,1191)