Meter Swap t
� Request Number: 14535
Public works Division
Seivice Request
Problem Address: 169 Horizon Circle Requested By: Peter Bo�steel
Departmeat: WA1ER Address: No address provided
Problem/Issue: IN5TALL AMR METER Pho�Nnmber: 572-1009
Scheduled Date: 2017-04-11 5c6ednled 1ime: .i�OR00G ��c3�
t ��
ACTION NEEDED:
Created by: Wendy Hiatt Date Cre�ed: 2017-04-OS
ACIION TAI�N:
____...�._c�,�...._� 1 �1�-�—
Status: In Progress Snbmitter Has Been r,
CoM�ted
Unte Completed: Com�eted 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 necessary to
replace the water meter. 1 understand that the property owner is liable for the water{ine from tfie main to the premise and all iMerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocwr while dang this
ope�ation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prio�to any work,if necessary. �
FINAL METER READING(old meter) ��!'" t/ � �� .
Name: �'��"1�x �jh�(�,`�,��'S1�lh� Address_ l � 1 ��('l Z..�� � .i 1�"
Phone Number J I��^ � ��� Date ���4r��
Signature Witness Signature
OLD METER# C�� � �"`I� � ✓
OLD READING �� d��� O
NEW METER# � y��� �' I �
NEW READING �
ERT# � ��Z �� S�
FRiDLEY CITY CODE
CHAPTER 4U2.WATER,STORM WATER AND SANITARY SEWER
ADMINiS7RATiON
(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 arry 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 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 wver
any conneding line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and witable wnnedion.
402.06 REPAIRS AND MAINTENANCE 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 servk�lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liabie 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 maintenance service or repairs be performed by the C'�ty,the property owner shall be charged for the tosts of the mairrtenance and/or
repairs,including necessary street repairs at a�ate set annually by an administretive po{icy. tt sha{I be the responsibitity of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mairrtain 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. jRef 638,1156,1191)