Meter Swap �
�' Request Number: 15073
Public Works Division
Service Request
Problem Address: 5268 Capitol St Requested By: Gloria Paulsen
Deputmeut: WA1FR Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-572-1150
Schednle� 2017-OS-04 � Sc6edaled Time: 01:30:00
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ACIION NEEDED:
Created by: Beth Kondrick Date Created: 2017-OS-O 1
ACIION TAI�N:
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Status: In Progress Sabmitter Has Been r,
Contncted
Dite Completed: �'_�_ � Completed by: �
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' City of Fridley � � � �
Water Department �
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
�/We hereby authorize the�ty of Fridley and/or its employees to do what is necessary to
reptace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all irrterior
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 include,but not limited to valves,piping,walls,floors or the wrb stop boz and senrice line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter�_ � � �����
Name: 171,1k7��, �G�v��� Address �� �'() (,.�� ,}�-
Phone Number ���""��� ^ �`)1J Date_ � �� L `� � 1
Si nature ��
B Witness Signature
OLD METER# 1 �✓ ���/ �
OLD READING � � � ���
NEW METER# � F� � L � -
NEW READING �
ERT# Y ���v��
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 existing municipal system and any house or buildir�for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permR 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 cover
any conneding line until an inspection has been made and wch connection and the work incident thereto has been approved by the Crty as a
proper and suitable connedion.
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 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 connection of the premises from the main to the premises. if the property owner
requests maintenance senrice or repairs be performed by the City,the property owner shall be charged for the wsts 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 applicant,
owner,occupant or user to perform standard maintenance of the sewer senrice line from the premises to the main including debris clearing or
root cutting and to mairnain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)