Meter Swap � �' Request Number: 14761
Public works Division
Service Request
Problem Address: 5225 Horizon Dr Requested By: Ingrid
M Department: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-273�6702
Scheduled ate: 2017-04-21 Sche uted Time: 11:30:00
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' AG"I�ON NEEDED:
� Created by: Wendy Hiatt Date Created: 2017-04-18 �
ACIION TAI�N: ,�--
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Status: In Progress Sabmitter Has Been r
Co�acted
Date Compteted: � � Completed by: `�
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+ City of Fridley
Water Department
6431 University Avenue NE
Fridiey, MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all iMerior
piumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocair while doing this
operation. This to include,but�ot limited to valves,piping,walls,floors or the curb stop box and sewice line. In undersWnd 1 am al�required
to obtain a permit prior to any work,ff necessary.
FINAL METER READING(old meter) � �� `�
Name: "�`,'1� l`� Address ✓��� �(�, `��Vl. �H •
Phone Number ������`� �/�'ate ' li� �� � "�
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Signature Witness Signature
OLD METER# ��` �� �O�
OLD READING ��`�"��J�
NEW METER# ���"" �� ` 1
NEW READlNG �
ERT# �""�����
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 municipal system and any house or buNding for whkh the
application is made,the owner or contrador shall be requi�ed to obtain a permit for such connection,and shall pay a permR 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 unlawtul to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the C�ty as a
proper and suitable coonection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the i�itial 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 extended to the property line for connection,the applicaM,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 of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shail 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 wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)