Meter Swap � �' Request Number: 14766
Public Works Division
Service Request
Problem Address: 4832 3rd St Requested By: Dennis Steveffion
Department: WA1ER Address: No address�ovided
Problem/Issne: INSTALL AMR METER Phone Number: 763-572-8891
Scheduled D ,te� 2017-04-28 Schednled Time: 10:00:00
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ACTION NEEDED:
Created by: Beth Ko�ick Date Created: 20l 7-04-18
ACIION TAI�N:
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Status: In Progress Sebmitter Has Besn r.
Co�acted
Date Completed: �`�] (�,�,�� Completed by: �
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� City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
t/we hereby authorize the City of Fridley 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 line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the Clty of Fridley and/its employees harmless for any damages that may ocwr while doing this
operation. This to include,but not limited to vaives,piping,walls.floors or the curb stop box and senrice line. In uederstand I am a{so required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) V �v �" �
Name:_ 6J'Q h�L 15 ��`�i�C�� Address �'� �� � '
Phone Number ���~���V� ) Date V� �� � 1�
Signature Witness Signature
OLD METER# ��� � �7� �� �`� � '
OLD READING �� �Gi��� `� �
NEW METER# � !� / �� I
NEW READING V
ERT# ���°'�� ��V
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 wnstructing or repatr of any water of sewer line connecting the existing municipal system and any house or building for whkh the
appiication is made,the owner or contractor shall be required to obtatn a permit for wch connection,and shal{pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. k 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 suitable rnnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service wrb stop box or the sewer lead at the property line or a water seroice lead has
been extended 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 li�e and sewer lines necQssary for connection of the premises from the main ta 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 maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative polity. It shall be the responsibility 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 wrb 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)