Meter Swap � t
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Request Number: 14531
Public works Division
Service Request
Problem Address: 129 Horizon Circle Requested By: Mr Dzubak
Departmeat: WA'IER Address: No address provided
ProMem/Issm: INSTALL AMR METER Phone Number: 572-1013
SchednledDate: 2017-04-26 �'�� Sc4edeled'lime: 10:00:00
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ACIION NEEDED:
Created by: Wendy Hiatt Date CYeated: 201?-04-OS �
ACIION TAI�N: `
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Status: In Progress ��tter H's Been �.,
Conhcted
Date Completed: Completed by:
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City of Fridley �O�j �� �
Water Department � �
6431 University Avenue NE �
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to�!o what�S netessary to
replace the water meter. I 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) 1 also hold the City of Fridley and/its employees harmless for any damages that may oc.�r while doing this
operation. This to include,but not limited 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) � �� � ��v
Name• �" �`S r �Z,�J �l!1�, Address L� ` �'LV� �z--�� � l��
Phone Number ,�J��� �v � v Date ��?iCJ � '�
Signature Witness Signature�
�0 1 �2-�t � 20�
O METER#
OLD READING ` ��C� �b�
NEW METER# � ` "� ����
NEW READING O
ERT#_ � � �iZ L—�j� C(.�Z
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or lwildir�for which the
application is made,the owner or corrtrador shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawFul to cover
any connecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the Clty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water service curb stop box or the sewer lead at the pwperty line or a wate�servi�lead has
been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shali be liable for all repairs
required to any water line and sewer lines necessary for conne¢tion of the premises from the main to the premises. If the property dwner
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,inciuding necessary street repairs at a rate set annually by an administrative poliry. It shall be the respo�sibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water senrice 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)