Meter Swap �
�-' Request Number: 14256
Public works Division
Service Request
Problem Address: 6192 East River Rd Requested By:
Depsrtment: WATER Addreas: No address pcovided
ProblemlIasue: INSTALL AMR METER Phone Nnmber:
Schednled Dste: 2017-03-22 Se�daled'Ilme:
AC'IION NEEDED:
Created by: We�xiy Hiatt 1Mte Cre�ed: 2017-03-22
.4CT70N TAKEN:
��; ���� Snbmitter Hu Baen r
Co�acted
Dxte Compteted: Completed by:
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I�•� - �{������ y� __ ��� �
City of Fridley
, � Water Department ��; � �Z��j
' 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. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Pridley andJits employees harmless for arry 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 1 am also required
to obtain a permit prior to any work,if necessary.
�`��� �r�o�-9�� rp,,���
FINAL METER READIN6(old meter)
Name: �►ddress �J ► ` � ��� �V C� �/
Phone Nu r _ Date
3�- - � � � �
Signature Witness Signature
OLD METER# ' l 1�V
OLD READING �� � Y�v
NEW METER# G �V��("7
NEW READING �
ERT# � � W � 4��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j �
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line wnnecting the existing municipal system a�d 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 provld�d in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shall be unlawful to cover
a�y connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the�ty as a
proper and suitable connedion.
402.06 REPAfRS AND MAl1�TENANCE 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 occupaot or user of such premises shall be liabie for ali repain
required to any water line and sewer lines necessary for wnnection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance and/or
repairs,including necessary street reqairs at a rate set annually by an administrative poliry. It shal{be tfie responsibility of the appilcant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris ciearing 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)