Meter Swap �
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Request Number: 14811
Public Works Division
Service Request
Problem Address: 4803 3rd St Requested By: Kaitlan Huber
Departme�: WA'IER Address: No a�ress�ovided
Problem/Issue: INSTALL AMR ME'IER Phone Nnmber: 651-285-0473
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Scheduled Date: 2017-04-24 Sc6edaled'iime: 01:30:00
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ACIION NEEDED:
Created by: Beth Kondrick Dste Crested: 2017-04-19
ACRON TAI�N:
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Status: In Progress Snbmitter Aas Been r,.
Co��cted
Date Completed: Completedby:
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City of Fridley �� � '" 2
Water Department
6431 University Avenue NE
Fridley, MN 55432
763-5723566
�/We hereby authorize the City of Fridley and/or its empbyees 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 iMerior
plumbing. (Par City wde 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to va{ves,piping,wails,floors or the curb stop box and service Iine. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
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FINAL METER READING(old meter)_ �'r C� �{ � ��
Name: /�ddress �,�0�S 3 '�'°�5-�`:
Phone Number Date
Signature Witness Signature
OLD METER#_ / � � � �� �S��
OLD READING LL (� b O I L� �
� NEW METER# �I � �. � � L v�
NEW READING �
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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 any water of sewer line connecting the existing muntcipal system and any house or building for which the
application is made,the owner or contrector 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 notffied. It shall be unlawful to cover
any wnnecting 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 suitable wnnection.
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 properly line or a water servi�lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be Itable for 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 be charged for the costs of the mairrtenance and/or
repairs,inciuding necessary street repairs at a rate set annualiy by an administrative poliry. It shall be the responsibiltty of the applicant,
owner,�cupant or user to perform standard mairnenance 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)
R���est for Service Re��r�
City �af ��ir�l�y
R efetcnce N�: �� `- C 2 -S�� � 6 ate: �a'���" ��
Rcquext Type: ���� ,,,,r� i_"1� Entcted By�
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Depaikmenk: Citizen t�ame: ;T^y �� h�'��
Address. �l(,,�l,,r�' �J ,w � ( Callback P4�ne:
Sched�ded date: Pro�ty Owner:
Lcrocation Qeta�: flequeat l�eta�s.
Action Taken:
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