Meter Swap �
, Request Number: 15079
Pubtic Works Division
Service Request
Problem Address: 5130 3rd St Requested By: Glennys Novak
Department: WATER Address: No a�lress provided
Problem/7ssue: INSTALL AMR ME1ER Phone Number: 763-572-1150
Scheduled D� • 201?-OS-OS � Sc6ednled 11me: 01:30:00
, S ���
AC1iON NEEDED:Please call on azrival,doorbell does�t worlr amd resi�ent is hard of l�aring and may nat hear
lmock on door
Created by: Beth Kondirick Date Cre�ed: 2017-OS-O 1
ACTTON TAi � •
_____.J��i� .
Status: In Progress S�biriitter IIas Been �.,
Contsicted
Date Completed: Completed by:
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� City of Fridley ('(/�� �q�s
Water Department �'�
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authori:e the tlty of Fridiey andjor its 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 premise and ali interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocair 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 I am also required
to obtain a permit prior to any work,ff necessary.
FINAL METER READiNG(old meter) � �� � ��
Name: �`"�h'�� J �����ddress �� �v ��`_ ��
Phone Number ������',���(JDate �� '�
Signature __ --- Witness Signature �
OLD METER#_ `� �� ����
OLD READiNG � � �� TJ��
NEW METER# — ` ����'� �
NEW READING `�
ERT# � � � � � �Z � :
FRlDLEY ClTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,652,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buildi�g for whid�the
application is made,the owner or contractor shall be requtred to obtain a permit for such connectlon,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 not�ed. It 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 connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connecCion has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the appficant,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. If the property�rner
requests maintenance service or repairs be performed by the City,the property owne�shall be charged for the c.osts of the maintenance andjor
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applipnt,
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�nished
grade of the land or property. (Ref 638,1156,1191)