Meter Swap .�
�� Request Number: 14760
Public Works Division
Service Request
Problem Address: 113 49th A�e Requested By: Jim DeRose
Department: WATER Address: No address�ovided
Problem/Issue: INSTALL AMR METER P6one Number: 572-8822
Scheduled Date: 2017-04-21 Scheduled 1lme: 09:00:00
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ACTION NEEDED:
Createdby: WendyHiatt DateCreated: 2017-04-18
AGTION T .
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Statua: In Progress 5abmitter H�s Been r,
Contacted
Date Completed: Completed by:
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City of Fridley
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
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and al!ir�terior
plumbing. (Per City code 402.06) i also hold the City of Fridley and/its empioyees 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)__ r � � a � ��
Name:_�11� I5/�dC i Address_ � 1 � �v�'� �
Phone Number �� ti [J�� Date � �� 1� � i
Signature Witness Signature
OLD METER# �/ ��� _` ���j
OLD READING � � I �V
NEW METER# � f �
NEW READING �
ERT# ��Z 1/� 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 exisfing municipal system and any house or�ilding for which the
appiication ls 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 shali be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 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 Me or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for wnnedion 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 maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. 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 debrts 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 flnished
grade of the land or property. (Ref 638,1156,1191)