Meter Swap �
'� Request Number: 15235
Public Works Division
Service Request
Problem.4ddress: 213 49th A� Requested By: Marjorie Peterson
Department: WATER Address: No a�ress provi�ed
Problem/Issue: INSTALL AMR METER Phone Number: 763-226-0505
5chedul d te: 2017-OS-10 `{ Sc6eduled Tlme: 11:00:00
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ACIION NEEDED:
Created by: Wend}+Hiatt Dnte Created: 201'7-OS-09
ACIION TAI�N:
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Status: In Progress Submitter Has Been r,
Contncted
Date Completed: Completed by:
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City of Fridley 7� rl
' Water Department ��� ` �'�`o
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
1/we hereby authorize the City of Fridley and/or its employees to do what is neoessary to
replace the water meter. I understand that the property owner is iiable for the water line from the main to the premise and all inte�tor
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to inciude,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In undetstand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) ���v ��
Name: �" LG�N,��J ��/ � "� v�1Y�, Address � �� ��� 1�
Phone Number _ l�p� �—V�o O��p�e ��' �'V �' ��
Signature ' Witness Stgnature
OLD METER# ����� ���
OLD READING �J�� �.J
NEW METER#��� ���J
NEW READING l�
ERT# � ���d���
FRIDLEY C171f CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house or building for which the
applicaCior+is made,the owner or contractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shall 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 aqproved by tfie City as a
proper and suitable connection.
402.06 REPAIRS AND MAi11tTENANCE 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 senrice lead has
been extended to the property line for connection,the applicant,owner,or ocwpant or user of wcfi premises shall be ltable for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the maiMenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative poliry. It shail be the responsibiltty of the applipnt,
owner,occupant or user to perform standa�d maintenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box for operability and at wch height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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