Meter Swap '�
� Request Number: 14553
Public works Division
Service Request
Problem Address: 5460 Horizon Dr Requested By: Mary Jotmson
Department: WA1ER Addreas: No address provided
Probtem/Issue: INSTALL AMR METER Phone Number: 763-442-4317
Schedul DAte: 2017-04-12 Schedaicd'Ilme: 11:30:t�
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ACTION NEEDED:
Crented by: Beth Kondrick Date Crested: 2017-t?4-Ob
ACTION TAI�N:
l��-S�t.... �-
Sts�tus: In Progress Sebmitter Has Been �..
ContActed
Da�te Completed: Completed by:
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City of Fridley
Water Department `�j��- ���j�
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�JWe 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 owne�is liable for the water line from the main to the premise and all intertor
plumbing. {Per City wde 402.06) f also hold the City of Fridley and/its ernployees fiarmless for any damages that may o�r while doing this
ope�ation. This to include,but not limited to vai�res,piping,walls,floors or the wrb stop box and service line. In understand{am also required
to obtain a permii prior to any work,if necessary.
FINAL METER READING(otd meter) � ,1� ( �
Name: � � Address �`�l�� ���� �r
Phone Number � ��� l c>� 1 Date �✓`� ��
Signature Witness Signature
OLD METER# () 1��J ��� J �
OLD READiNG � ` i �VO
NEW METER# � 4 w ���
NEW READiNG V
ERT# � Z����� 1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMiNiSTRATION
(Ref Ord No 113,46�4,565,566,629,538,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or build[ng for which the
appiication is snade,the owner or contractor shail be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department sha116e notiffed. !t shal!be unlawful to cover
any connecting line until an inspection has heen made and suth connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECT{ON
After the initiai connection has been made to the water senrice curb stop box or the sewer tead at the property line or a water service lead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of such premises shail be Habie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. 1f the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the cosis of the mairrtenance andjor
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali be the responsibtlity of the appficant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main induding debris clearing or
root cutting and to maintain the water service curb stop box foroperability and at such height as wiil ensure that it remains abave the fiinished
grade of the land or property. (Ref 638,1156,1191)
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city ot Fridlep
' Water Depa�tment �
Address J rC1� ��Z.c�� �.
Name �t�L�1�13 �4U1•�
Date ��"'� 'l�"�`"I `
Old Meter Number � '1�� �� _
Old Meter Reading �� _ ,
Replacement No. �t���� J�
Replacement Reading �
Replacement Make__��'.���t'�'�-
Remarks: b�� ��Y���-
Signed��
. ADDRESS: 5460 HORIZON DR NE PERMIT NO. 20c�9-b 159�
DATE: 10/21/2009 TIME: INSPECTOR: (None)
INSPECTION TYPE: FINAL PERMIT KIND: PLUMBING-Fixture Based/RESIDENTIALNALVE R]
NOTES:
NEW METER 36077855
METER READING...0003870.
SEALED METER
STATUS: INSPECTOR:
INSPECTION NOTES:
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