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Meter Swap .� 4 Request Number: 15051 Public works Division Service Request Problem Address: 5190 3rd St Requested By: Harriet Ewing Depsrtme�: WATER Address: No address provided ProMem/Issue: 1NSTALL AMR METER Phone Nnmber: 763-586-0923 Schednled Date: 2017-05-08 Schednled 1Ime: 07:30:Of1 ACIION NEEDED: Created by: Beth Kondrick Date Created: 2017-04-28 ON TAI�N• �� Status: In Pro ss Snbmitter H�Been �, � Co�acted Date Completed: Completed by: S-- g- �7 7`� !o r � a lV2 �" ��'� [ C� ��2 � City of Fridley �� � ` � �3 Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 �/We hereby 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 line from the main to the premise and all iMerio� plumbing. (Per City code 402.06) I also hold the City af Fridley and/its employees harmless for arry damages that may occur while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. in understand i am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) v "—' �t/ `�O Name:���Y \ ��� `'�--1�� Address� -I D �1�� �� Phone Number �V _���� ��ate �� �^ �� Signature `� � �-- Witness Signature OLD METER# � C��`"1 `�J"� � OLD READING V � �O r�O NEW METER# 1� `V� NEW READING O ERT# � � C�Z 4�� � 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 constructing or repair of arry water of sewer line connecting the existing municipal syslem and arry house or buildi�for which the application is made,the owner or contractor shall be required to obtain a permit for wch 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 City as a 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 Itne or a water service lead has been extended to the property line for connection,the applicar�t,owner,or occuparrt 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 property owner requests maintenance service or repairs be performed by the City,the property 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 o�f the applicant, owner,occupant or user to perform standard mair�teoance of the sewer service line from the premises to the main induding debris�learing or root cutting and to maintain the water senrice 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)