Meter Swap � `,
Request Number: 14681
Public Works Divisiott
Service Request
Problem Address: 200 53rd Ave Requested By: Dvvayne Home
Department: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-245-1974
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r Schedttiled Dafe: 2017-04-19 Scheduled'Ilme: 07:00:00
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ACTiON NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-14
ACTION TAI�N:
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Submitter Has Been �
Status: In Progress Contacted C
Date Completed: �_ I G_ �1 Completed by: ( � ��;
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City of Fridley S� � 3(p��
Water Departrnent
6431 University Avenue PIE
Fridley,MPI 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 matn to the premise and all interior
piumbing. (Per City code 402.06) 1 also hold the City of Fridley and/'rts employees harmless for arry damages that may occur while doing this
operation. This to incfude,but not timited to vatves,piping,walls,floors or the curb stop box and service line. I�understand i am also required
to obtain a permit prior to any work,if necessary.
FtNAL METER READING(old meter) O 1 �� ��D
Name: � ��� �UI'w�' Address ��� ")�r� ��
PkoneNumber ��Q�' �%�' 'y7 y p�_ _t— � 'C( — ��
Signature Witness Signature ��
OLD METER# �� 3 �
OLD READING ��J / I�Q
NEW METER# � I��/� � �YJ
NEW READtNG v
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRA►TION
(Ref Ord Plo 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repaic of any water of sewer line connecting the existing municipal system and any house or Iwitding for whid�the
application is made,the owner or corrtractor shali be required to obtain a permit for such connedion,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 notified. It shall be unlawful to wver
any connecting line until an inspedion has been made and such connection and the work incident thereto has been appro�red 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 line or a water seroice lead has
been extended to the property line for connection,the applicairt,owner,or occupant or user of such premises shall be Itable for ali repairs
required to any water line and sewer lines necessary for wnnection of the premtses from the main to the premises. If the property�rner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of t�e mairKertartce and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. it shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding 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 flnished
grade of the land or property. (Ref 638,1156,1191)