Meter Swap � � Request Number: 14758
Public Works Division
Service Request
Probiem Address: 5269 Capitol St Requested By: Urgyen
Department: WA'IER Addreas: No address provided
Problem/�ssue: INSTALL AMR ME'IER Phone Number: 612-703-2119
Scheduled Date: -04-20 5c6eduled TSme: 07:30:00
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AGTION NEEDED:
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Created by: Wendy Hiatt Dnte Created: 2017-04-18
ACTION TAI�N:
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Status: In Progress Snbmitter Has Been r
Contacted
Date Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the�ty of Fridiey and/or its employees to do what is necessary to
replace the water meter. 1 understand tlwt the property owner is liable for the water line from the main to the premise and all interior
piumbing. (Per City code 402.06) 1 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,walis,floors or the curb stop box and service line. In understand I am atso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �� �� � �"
Name• Address � � ����� �
Phone Number_ �r r�JJ � bate �� w � �
Signature Witness Signature
OLD METER# ��� \ ��E.� �
OLD READING ���� � �
NEW METER# � `� �2� �Zi �3
NEW READING O
ERT# I �-2— I � � � �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAPIITARY 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 building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,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 shali be unlawful to c.over
any connecting line until an inspection 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 been made to the water service arb stop box or the sewer lead at the property line or a water s�rvice 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. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repain at a rate set annually by an administrative poliry. It shall be the responslbtlity of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing 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)