Meter Swap �
� Request Number: 15131
Public Works Division
Service Request
Problem Address: 4650 3rd St Requested By: David Santoyo
Deputment: WA'lER Address: No a�ddress provided
Problem/lssue: INSTALL AMR ME1ER Phone Nnmber: 763-843-8446
Seheduled Date: 2017-OS-06 Schednled 1lme: 08:30:00
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ACIION NEEDED:
Created by: Beth Kondrick Date Cresited: 201?-Og-03
ACITON TAI�N:
Status: Completed Submitter Has Been �..,
Contacted
Date Completed: Completed by:
Hours
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the Uty 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
plumbing. (Per City code 402.06) I also hold the City of Fridiey and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIN 1 `���
G(��meter)_ � �
Name:_ D J b.�� �(�'ESy 0 Address � �`� "'r
PhoneNumber ��7`1'�� 7� U�l�� Date ����� �
Signature Witness Signature V �.>
OLD METER# ��V � v�
�
OLD READING `�` �b ` �b
_ ---=�-.-,. -._�-
NEW M�ER#� II III�IIIIIl��II �� �--
NEW READING . 492OSOS2
ERT# IIIII IIIIII I III IIII III E
— 1 'I 72223676
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 conneding the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtaio 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 shatl be notified. It shall be unlawful to cover
any connecting line until an inspedion has been made and such connection and the work incident thereto has been approved by the City as a
proper and witable 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 Ilne or a water servke lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shall be liable for ali repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the properLy awner
requests maintenance service or repairs be performed by the City,the properly owner shall be charged for the costs of the mairrtenance 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 induding deb�is dearing or
root cutting and to maintain the water service curb stop box for operabil'ity and at such height as will ensure that it remains above the tinished
grade of the land or property. (Ref 638,1156,3191)