Meter Swap ,
� Request Number: 15405
Public works Division
Service Request
Problem Address: 4560 3rd St Requested By: Brian
Departmeut: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nnmber: 571-4523
Sc6ednled Date: 2017-OS-25 Schednled 1lme: 02:00:00
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ACTiON NEEDED:
Created by: Wendy Hiatt Date Crested: 2017-OS-17
�N TAI�N: � ��_^
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Status: In Progress Snbmitter Has Been r
Cont�cted ,
Date Compteted: Com�eted by:
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'� City of Fridley I D� � �`1 � r�� ��
'� Water Departrnent
6431 UniversityAvenue NE S� � � '3�
Fridley,MN 55432
763-572-3566
��We hereby authorize the City of Fridiey and/or its employees to do what is necessary to
replace the water meter. 1 undentand that the property owner is liable for the water lFne from the mairt io the premise and al!interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for am/damages that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop boK and senrice line. In undersWnd i am also required
to obtain a permit prior to any work,if necessary.
FINA1 ME7ER READIN6(o!d meter) �Z� � � � �
Name• Address��� �1�� ��
Phone Number �����1��p� �—��� ��
Signature Witness Signature
OLD METER# � � `2� � ��
OLD READING ���� I ` Q
NEW METER# `�L� V V ���
NEW READING O
ERT# �� J� v � J I
FRIDlEY ClTY 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 constructing or repair of any water of sewer tine connecting the existing municipa(system and any house or buildirig for whkh the
application is made,the owner or contractor shall be required to obtain a permit for such�nnection,and shail pay a permit fee as provkied in
Cbapter 11 of this Code. After such connection has been made,the Water and Sewer Departmern shall be notified. it shall be unlaw/u!to cover
any connecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the City as a
proper and suitable connectio�.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property Ifne or a water sen�ie kad has
been extended to the property line for wnnection,the applicarrt,owner,or occuparrt or user of wch premises shall be liable f�all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall t�charged for the cosGs of the maintenance and/or
repairs,includi»g necessary street repairs at a rate set annaally by an admirtistrative policy. !t shal!be the responsibilky of the applicaM,
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)