Meter Swap � Request Number: 14866
f Public works Division
Service Request
Probiem Address: 4885 3rd St Requested By: Tom Dirtz
Depsrtment: WATER Address: No address provided
Probletn/Issue: INSTALL AMR METER Pho�Number: 763-291-3581
Scheduled Date: 201�-0., .' $�,, Scheduled 15me: 10:30:00
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ACIION NEEDED:
Created by: Beth Kon�drick Date Created: 2017-04-21
ACITON TAI�N:
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Status: In Progress ��tter H�Been r
Contacted
Date Completed: �� 1 ��(� Completed by: �a��
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City of Fridley
� Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or tts 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 prcmise and all interior
piumbing. (Per City code 402.06) i also hold the�ty of Fridley and/its employees harmless for any damages that may oca�r 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 READING{old meter) ` 1 `'�� �� �
Name: "��� ����� Addreu - 1 V � �rd 5-� •
Phone Number �� � �� I v 3�� Date �� �� '� ��
Signature Witness Signature
OLD METER# ���ll��� �
OLD READING ���lJ ���
NEW METER# 1 ��d v�L`�
NEW READING �
ERT# �a� a,� � 5�
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 existing municipal system and any house or building for which the
appiication is made,the owner or coMractor shall be required to obtatn 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 notlfied. It shall be ualawfui to cover
any connecting line until an inspection has been made and such connectton and the work incident thereto has been approved by the City as a
proper and suitable 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 properly line or a water service lead has
been eztended to the property line for connection,the applicarrt,owner,or occupant or user of such premises shall be liable 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 mainte�ance service or repairs be perFormed by the City,the property owner shall be c6arged for the costs af the mairrtenance a�d/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility af the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris ciearing 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)