Meter Swap r
'" Request Number: 14962
Public works Division
Service Request
Problem Address: 5124 Horizon Ih Requested By: Frances Boct�et
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 612-532-1395
Schedule e: 2017-04-2� Sc6ednled 1tme: 07:30:00
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AG7ION NEEDED:
Created by: Beth Kondrick Date Crss�ted: 2017-04-26
A ON TAI�N:
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Status: In Pro�ess Submitter Has Been r.,
Contacted
Ds�te Comp{eted: Completed by:
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` City of Fridley � � ✓��7
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�lWe bereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and at1 irrterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may ocau while doing this
operation. This to include,but not limited to vahnes,piping,walls,floors or the curb stop box and service line. in understand I am also requfred
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �"� ` ��
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Name: Address ' � ���. �� r
Phone Number '�✓► ✓+ cl��� ���lJ pate _�,�� ` — `�
Signature Witness Signature \
OLD METER# v'�� ����
OLD READING � �U� Z��
NEW METER# —`- 1 (�lJ � ,�J J I
NEW READiNG �
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FRIDLEY CITY CODE
CHAPTER 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 connecting the existing municipai system and arry house or building for whi�the
application is made,the owner or wntractor shail be required to obtain a permit for such�nnedion,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shali be notified. it shall be unla+aful to�ver
any connecting line urrtii an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been eutended to the property line for connection,the appiicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connectio�of the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including�ecessary street repairs at a rate set annually by an administrative poliry. tt shall be the responsibility of the applipnt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main includir�debris dearing 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 638,115b,1191)