Meter Swap � ,�
Request Number: 14701
Pubfic Works Division
Service Request
Problem Address: 5229 Capitol St Requested By: Dale Broadhall
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-718-7373
Scheduled Date: 2017-04-19 Scheduled'Iime: 01:30:00
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ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-14
ACTION TAi�N:
............:..........l._�.�:�.-��.�_1............:.__..�N��..:._.................._�.............................................__.__..............................._._................._._.._....w._..............._._.:.....__.____._.......____
Status: In Progress Submitter Has Been C
Contacted
Date Completed: Completed by:
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City of Fridley � ��/„/�,�//
Water Department (���� r
6431 University Avenue NE
Fridley,MN 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 main to the premise and all iMerior
plumbing. (Per City code 402.06) I also hold the C'ity of Fridley and/its employees harmless for any damages that may ocaar whtle dang this
operation. This to include,but not limited to valves,piping,walls,floors or the aarb stop box and service line. In undentand I am also required
to obtain a permit prior to any worlc,if necessary.
FINAL METER READING(old meter) � �� �� �
Name: �6�,�'"� �r���'l�Gl, I Address_��l�-- 1 �71� tl 1
Phone Number �✓���� `������ Date � � � � � ��
Signature Witness Signature
OLD METER# � ��� ���
OLD READING � I�� � � �
NEW METER# � 1 G�� `�' � ��
NEW READING_V
ERT# � � L I 1 � J �
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 ezisting municipal system and any house or building for which d�e
application is made,the owner or wrrtrador shali 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 DepartmeM shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work inddent 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 curb stop boz or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,tbe applicaM,owner,or occupant or user of such premises shall be liabie 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 properly owner
requests maintenance service or repairs be performed by the Ciiy,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maiMenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service cu'b stop box for operability and at such height as witl ensure that it remains above the�nished
grade of the land or property. (Ref 638,1156,1191)