Meter Swap �
�, " Request Number: 15050
Public works Division
Service Request
Problem Address: 4590 3rd St Requested By: Pam Robinson
Departmeat: WA'IER Address: No address p�ovided
Problem/Isaue: INSTALL AMR ME1ER Phone Number: 612-244-6002
Scheduled DAte: 2017-OS-04 Sc6ednled'ISme: 11:OO:W
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ACIION NEEDED:
Created by: Beth Kondrick Date Created: Z017-04-28
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AC I�ON TAI�,N: �
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St�us: 1n Progress �bmitter Haa Been r, } . ,
Contacted '
Date Completed: � � '� Completed by: ��`L� -
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� City of Fridley
Water Departrnent s b ,� 3��-'2
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
VWe hereby authorize the City of Fridtey and/or its employees to do what is necessary to
replace the water meter. t 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 hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this
operation. This to inciude,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In understand 1 am al�required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter] ���� O
Name• ��� ����t�� Address �� 1,� �� J'*'%
Phone Number `���"� v" �" f � �w� p�e � 'y � ( `� ��.
Signature Witness Signature
OLD METER# � �/ ��� ���
OLD READING 0��� �O
NEW METER# � ` �� ��� I
NEW READING v
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ERT# � ��"p� v�� 1
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 buildir�far which the
application is made,the owner or contractor shail be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shall be untawfui to co�rer
any connecting line unti(an inspection has been made and such connection and the work incident thereto has been approved by the CIty as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After tha initial conoection has been made to the water service curb stop box or the sewer lead at the property line or a wate�senrice lead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of wch premises shali 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. If the properly owner
requests mairrtenance senrice 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 policy. It shall be the responsibility af the applipM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris dearing or
root wtting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the tinished
grade of the land or property. (Ref 638,1156,1191)