Meter Swap *�
� Request Number: 15084
Pui�lic Works Division
Service Request
Problem Address: 5273 Horiwn Dr Requested By: Serena
Department: WATER .Address: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-598-490Q
Schednled te: 201'7-OS-OS 5chednled 11me: 07:00:00
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AGTION NEEDED•
Create@ by: Wendy Hiatt Dnte Cre�ed: 201'I-OS-01
,,�ACIION TAI�N•
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St�us: In Progress Snbmitter Has Been r
Contacted
Date Compteted: Completed by:
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City of Fridley
Water Department � ,� �?�'�(r
6431 University Avenue NE �
Fridley,MN 55432
763-572-3566
�/We hereby authorize the C'�ty of Fridiey and/or its employees to do what is�ecessary to
replace the water metPr. i understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this
operation. This to include,but not limited to va(ves,piping,watis,floors or the curb stop box and senrice line. In understand t am atso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � ��� �� �
Name:��C/�, Address ��� � ��'1�� DY"
Phone Number_YJ��r ✓ ��~ � I�ate �� � v ��
Signature Witness Signature ��_�
OLDMETER#_ � �O �9 10�� �
OLD READING `''l`l v`► �v �
NEW METER# � f��v � � �
NEW READlNG �
ERT#_� �� 1 Z1� ��
FRtDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANRARY SEWER
ADMINiSTRAi'tON
(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 ar buildiryt for which the
application is made,the owner or contractor shail 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 unlavvful to cover
any connecting 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 suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONMECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the properly line or a water service lead has
been extended to the property line for connection,the appliwrrt,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 maintenance service or repairs be performed by the City,the property owner shai(be char�ed for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annuatty by an administrative poliry. It shal!be the responsibility of the applicant,
owner,occupant 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 638,1156,1191)