Meter Swap n
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Request Number: 15113
PubNic Works Division
Service Request
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�roblem Address: 4739 3rd St Requested By: Mike Kanis
Department: WATER Address: No a�ress p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 572-0681
Sc6eduled D te: 2017-OS-OS Schednied'IIme: 09:00:00
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' ACTION NEEDED:
��--<;,, Crexted by: Wendy Hiatt Date C�eated: 2017-OS-03
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�ACITON TAI�N:
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....__....._.._..__........_.._..�._.._..__._....._........_._....__.. .._._........_...._.._._........._____ ___..�..__..._ __._...___..._._....,._. � =f� � ��"'�.
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Status: In Progress Sabmitter Has Been �., � `
Contacted
Date Completed: �`L,_�� Completed by: 1�
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City of Fridley �j� 3�133
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Pridley and/or its employees to do what is oecessary to
replace 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 hold the City of Fridley and/its employees harmless for any damages that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb 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) � � � �� v �
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Name• �W Ui S Address
Phone Number � / ����v ` Date �� �J r� l
Signature Witness Signature
OLD METER# �d� �� ` / l
OLD READING ��� ��� �
NEW METER# '�[ R� V ��O�-
NEW READING �
ERT# i d�o� J3��Q
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 existi�g 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 shall be not�ed. It shall be unlawful to cover
any connecting line until an inspection has been made and such rnnnection and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the i�itial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of sach premises shall be liabk for ali 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 maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the malMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applipnt,
owner,occupant or user to perform standard maintenance of the sewer senrice line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)