Meter Swap , � Request Number: 15104
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Public Works Division
Service Request
Problem Address: 4756 3rd St Requested By: Nicole Hertel
Department: WATER Addresa: No address pmvided
Problem/Issue: INSTALL AMR METER Phone Number: 651-605-147b
5chedW ed Date: 2017-OS-03 Schedele�'Rme: 08:30:00
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ACIION NEEDED:
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Created t►y: Wendy Hiakt Unte Cresited: 2017-OS-02
AC"IION TAI�N: �
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3txtus: In Progress 3�bmitter H�Been �.
Cont�ted
Dmte Completed: �� � 9 �� Completed by:
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City of Fridfey
, Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace the water meter. I 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 ho{d the City of Fridley and/its empioyees harmless for any damages that may ocar while doing this
operation. This to include,but not limited to valves.piping,walls,floors or the curb stop box and service line. fn understand 1 am afso required
to obtain a permit prior to any work,if necessary.
FiNAL METER READING(old meter) ✓ �� ��v
Name: � ��i���° ����I Address � 1��6' � � ,
Phone Number '�✓�✓�d� ^` `�� Date �� � "�
Signature Witness Signature
OLD METER# '`�� � �����
OLD READING ��� ��—�
NEW METER# l t�� LJ�� (
NEW READING O
ERT# ! ���.3I ! �
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 municipal system and any house or building for which the
application is made,the owner or contractor 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 sha{I be notified. It shall be unfawfut 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 wnnection.
�02.06 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 line 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 repatrs
required to any water line and sewer lines necessary for connect(on of the premises from the main to the premises. ff the property owner
requests maintenance service ar repairs be performed by the Gty,the property owner shail be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative pofiry. it shall be the responsibility of the appliqnt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing 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 tand or property. (Ref 638,1156,1191)