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Meter Swap ! � Request Number: 14504 Public Works Division Service Requ�est Problem Address: 5409 Horiwn Dr Requested By: Hirtch Departme�: WA'IER Addresa: No address p�ovidcd Problem/Issm: INSTALL AMR ME'lER Pho�Nnmber: 7b3-57Z-9587 Sc�eduled Ih�te: 2017-04-11 Se6eduied 11me: 10:00:00 n ��' ACIION NEEDED: Created by: Beth Konchick Date Cret�ted: 2017-04-04 ACIION TAI�N: ��`� `�� Ststus: In Progress Snbmitter Has Been r, Contacted Date Completed: Com�eted by: �� � `—�� � ��r. � � .,� � � ��_. � �i ��� � � � City of Fridley CD �- ���� Water Department �J 6431 University Avenue NE Fridley,MN 55432 763-572-3566 i/we hereby authorize the City of Fridley and/or its employees to do what�S necessary to replace the water meter. f 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 Frid{ey and/its empioyees harmless for any damages that may occur while doing this operation. This to inctude,but not lim+ted 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. FINAL METER READING(old meter) �� O� O� � Name:���Y\ Address �`�i v 1 YC���Z�� �1� Phone Number��c ) V�����Date �'� \ ,� Signature Witness Signature `� ��~ OLD METER# ��� 1 I ��� OLD READING ���� \ )� �/ NEW METER# � r V v� � 1 � NEW READING D ERr# '1, 2�-�--Z-�' � FRIDLEY CiTY CODE CHAP7ER 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 constructing or repair of any water of sewer line conneding the existing municipal system and arry house or buitding fo�which the application is made,the owner or wntractor shall be requi�ed to ohtain a permit for wch connection,and shaH pay a permit fee as provided in Chapter 11 of this Code. After such connedion has been made.the Water and Sewer Department shall be notified. It shall be unlawfuf to cover any connecting line until an inspection has been made and such wnnection and the work incident thereto has been appsoved by the City as a proper and suitable connedion. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initiat connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water setvice lead has been extended to the property line for connection,the applicarrt,owner,or occupant or user of wch premises shall 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 properry owner requests maintenance service or repairs be perFormed by the City,the property owner shail be charged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set annuaily by an administrative policy. It shall be the responsibility of the appliwnt, owner,occupar�t or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing 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 638,3356,1191)