Meter Swap � � Request Number: 14938
Public Works Division
Service Request
Problem Address: 112 Gibraltar Rd Requested By: Joseph
Department: WATER Addresa: No address provi�d
ProWem/Iasne: INSTALLAMRMETER P6oneNumber: 651-494-7162
Scheduled Date: 2017-04-27 Sc6ednled'ISme: 11:00:00
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AC110N NEIDED:
CreAted by: Beth Kondrick Date Created: 201?-04-24
ACTION T.�I�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 City of Fridley and/or its employees to do what is nexssary to
replace the water meter. I understand that the property owner is liable for the water line from The main to the premise and ali interior
plumbing. (Per City code 402.�) 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 curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FiNAI METER READING(old meter) �� �' ���
Name: Y\. Address _ � �� �i��`� �
Phone Number � " � `- {�� ���Date �," ��'� ��
Signature \ YYitr�ess Signature
OLD METER# I �� c(7 "I�Z�JI)
OLD READING ���I �bV
NEW METER# �� w�� ��
NEW READING �
ERT# � ����� L c7. 1
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 construding 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 co�tractor shall be required to obtain a permit for such connection,and shaii 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 shall be uniawful to cover
any wnnecting line until an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAIWTENANCE 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 appliqnt,owner,or occupant or user of such premises shall be liable for ali 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 mairrtenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rete set annualiy by an administrative policy. It shail be the responsibility of U�e applicant,
owner,occupant or user to perform standard mais�tenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)