Meter Swap �
� Request Number: 14762
Public Works Division
Service Request
Problem Address: 5249 Horizon Dr Requested By: Beth
Department: WA'IER Address: No ac�ress provided
Problem/I�sue: INSTALL AMR METER Phone Number: 763-586-9636
Sc6eduled Date: 2017-04-2 Sc6eduled 11me: 02:00:00
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ACTION NEEDED:
Created by: Wer�dy Hiatt DAte Created: 2017-04-18
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Status: In Progress 5ubmf tter Has Been �
Coirtacted
D�te Completed: Completed by:
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City of Fridley U �
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 properly owner is liable for the water line from the main to the premise and ali iMerior
plumbing. (Per City code 402.06) I aiso hold the City of Fridley and/its employees harmless for any damages that may ouur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) v 1� � �`Y
Name• � Address � 1 1
Phone Number__ [����� ��� t"���� � '�
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Signature_ \ Witness Signature
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OLD METER#
OLD READlNG Z � c� � ��
NEW METER# "'I"I W��� J
NEW READING_� \
E�# �1222 �20�-1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANI7ARY SEWER
ADMINISTRATION
(Ref Ord No 113,454,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer Iine connecting the existing municipal system and any house or buiWing for which the
appiication 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 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to wver
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 CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property Ifne or a water senrice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such 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 property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs ot the mairitenance and/or
repairs,including necessary street repairs at a rate set annually by an admieistrative poliry. It shall be the responslbilFty af the applicani,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris deaNng 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)