Meter Swap �
.
� Request Number: 15085
Pubhc works Division
Service Request
Problem Address: 101 53rd A�ne Requested By: Rosa
Department: WA1ER Address: No address provided
Problem/Issue: INSTAL,L AMR METER Phone Nwnber: �63-756-8334
Scheduled Date: 20I7-OS-02 �� 6edoled Time: 11:00:0(i
ACTION NEEDED:
Created by: Beth Ko�lrick Date Crented: 2017-05-01
A ON TAI�N:
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Status: Tn Progress Snbmitfer HAs Been �..,
Co�acted
D�te Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
UWe 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 Itable for the water line from the main to the premise and all imerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for arry damages that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � V� °`-'�-i`�./
Name:__�� Address 4� ` � ( )�d �
Phone Number /�� )��CJ^��� Date ���✓ v�
Signature � Witness Signature
OLD METER# ��� ✓ I`� ��
OLD READING L� �l Jl 1 )
.
NEW METER#�7�"6 l.� � I ��
NEW READING �
E�# � I � L �-���
FRtDCEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 1I3,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipa!system and any house or building for whkh the
application is made,the owner or coMractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notified. It shall be unlawful to wver
any connecting line until an inspection has been made and such wnnection 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 wnnection has been made to the water service curb stop box or the sewer lead at the property tine or a water ser�ce lead has
been extended to the property line for wnnedion,the appl'icant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for conne¢tion of the premises from the main to the premises. If the properly owner
requests maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annuatly by an adminFstrative poliry. It shall be the responsibiliry of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service 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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)