Meter Swap �
4 Request Number: 14763
Public Works Division
Service Request
Problem Address: 161 Gibraltar St Requested By: Dale Otterness
DepArtment: WATER Address: No address provided
Problem/Tssue: INSTALL AMR METER Phone Number: 763-572-8220
Scheduled Date: 2017-04-25 Schednled'Rme: 01:30:00
_y;. �-� _ �'' I ' 3 �
AC'IION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-18
_�:.
ACTION TAI�N:
........._.... ................ ........_.._ ...._... s�.��-�,�t,e� ��.,{�.-_.�
Status: In Progress Submitter Has Beea r
Contacted
Date Completed: �— �y_ `"1 Completed by: J���
��i'pia:'+ .
�
r..i�`.
.L.'
..•M�.:�',:.:: . .
. � � �� L��j � on� - D )
` S� �- �� tg
City of Fridley
Water Department
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 City of Fridley andrts employees harmless for any damages that may occur while dang this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand I am also required
to obtain a permit prior to any work,if necessary.
�� �,��j C f C� �
FINAL METER READING(old meter)
Name: Ikl�� O��' `G �J Address �`�+�' ti����� ✓�'�
Phone Number. �lL �J—���` V�v Date �~ �� " `
Signature Witness Signature
OLD METER# -L� � a� � 1 �-
OLD READING �� i ` l `'v
NEW METER# 1 1� ����
NEW READING �
ERT# �G�����""
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINtSTRATION
(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 buildi�for which the
application is made,the owner or corrtractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspedion has been made and such co�nection 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 senrice curb stop box or the sewer lead at the property line or a water senAce kad has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shail 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 service or repairs be performed by the City,the property owner shall be ch�rged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shail be the responsibility of the applicant,
owner,oaupant or user to perform standard maintenance of the sewer service line from the premises to the main inc�uding debris clearing o�
root cutting and to maintain the water service wrb stop box for operability and at such height as wili ensure that it remai�s above the fi�ished
grade of the land or property. (Ref 638,1156,1191)