Meter Swap a
• Request Number: 15049
Public works Division
Service Request
Problem Address: 117 53rd Ave Requested By: Hegdahl
Department: WA1ER Addreas: No ad�ess provided
Problem/Issue: INSTAI.L ANIR METER Phoae Nnnber: 763-572•9724
ScNeduled Date: 2017-OS-03 Sc6ednled 1Ime: 0�:30:00
� 1
ACIION NEIDED:
Crexted by: Beth Kondrick Dxte Created: 201?-04-28
ACITON TAI�N:
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status: 1n Progress snbmitter Haa seen �,
Co�acted
Dxte Completed: Completed by:
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City of Fridley �Q � ���
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 ts necessary to
repiace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all ir�terior
piumbing. (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 include,but not limited to valves,piping,walls,floors or the curb stop box and service lioe. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READtNG(old meterj I � �� "�-� i O
Name• Address � �� ��� �
Phone Number !��� ��Z � �'� lJ ��
Signature v \ Witness Signature
OLD METER# ���'"I- 1 +
OlD READING �� �J� b- 1 O
NEW METER# � �I � V� � � �
NEW READING O
E�# �► 1 � � 2� 2�
FR{DLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMtNISTRATION
(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 connecti�g the existing municipal system ar�l any house or building for which the
application is made,the owner or corrtractor shall 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 shali be notified. It shall be unlawfui to cover
any connecting line urrtil an i�spection has been made and such 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 heen made to the water service curb stop box or the sewer lead at the property line or a wate�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 ali repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the properly owner
requests maiMenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. it shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including deb�is clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the ftnished
grade of the land or property. (Ref 638,1156,1191)