Meter Swap �
� Request Number: 15348
Public works Division
'H ' Service Request
ProWem Ad�ress: 4578 3rd 5t Requested By: Barb
Department: WA'IER Address: No ad�ess provided
ProblemlIssue: INSTALL AMR METER Phone Number: 763-572-1566
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Schedule��te: 2017-OS-16 T Schednled 1lme: 11:30:00
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ACTION NEEDED:
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>`'� Created by: Beth Kox�rick Date Created: 2017-OS-15
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ACTTON TAI�N:
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5tatus: In Progress Snbmitter Aas Been r
Co�sicted
Date Compteted: �� �� � � � Completed by:
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City of Fridley � (,� l�a
Water Departrnent �
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
VWe 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 owner is liable for the water line from the main to the premise and all interior
piumbing. (Per City code 402.06) I also hold the City of Fridley and(its employees harmless for any damages that may occur white doing this
operation. This to include,but not limited to vaives,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) ���� I " D
Name: l )�b Address ��� V ��� � •
Phone Number_ ���- 5�a `�C��� Date � � ��r � !
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Signature Witness Signature
OLD METER# �� / ����/
OLD READING ✓��� ��
NEW METER# � t��� - ( l �
NEW READING d
ERT#_ J � ! � 1 3 cl�
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 construding or repair of any water of sewer line connecting the exfsting municipal system and any house or buildi�for which the
application is made,tfie owner or contractor shali 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 Departmer�t shali be notified. tt shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been appro�red by the City as a
proper and suitable connection.
402.06 REPAIRS APID 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 service lead has
been extended ta the property 4ine for connection,the applicant,owner,or occuparit or user of such premises shall be Nable 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
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. 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)