Meter Swap �
� Request Number: 15038
Public Works Division
Service Request
Problem Address: Sd13 Hughes Ave Requested By: Jolm Zimmer
Department: WATER Addrees: No address provided
Problem/Iss�: INSTALL AMR METER Phone Number: 763-502-8470
Sc�eduled Date: 2017-OS-01 Schedaled 1lme: 01:00:00
S�
ACITON NEEDED: �
Cre�ed by: Beth Ko�drick Dnte Cre�ed: 2017-04-28
ACIION TAI�N:
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Status: In Pro ss Snbmitter Iin�Been �.,
� Co�atted
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Date Compteted:�_ I _ �� Completed by:
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City of Fridley �O � �� t �
Water Departrnent
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employeea to do what�necessary to
replace the water meter. i understand that the property owner is liable for the water lioe from the main to the premise and all irtterior
plumbing. (Per City code 402.06j i aiso hold the City of Fridley and/its employees harmless for any damages that may oawr while doing tf�is
operation. This to include,but not limited to vaives,piping,walis,floors or the curb stop box and service line. In understand 1 am aiso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �
Name• c�C� � W� �►vV1V w� Address V 7 �
�j � I ��
Phone Number ����' v�`' Date_ V r \
Signature Witness Signature
OLD METER# ��� � ��
OLD READING � Ir'7��v
NEW METER# 4 1 O�� �� t
NEW READiNG `� �''
ERT# � �" �� � ✓�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,4C�,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 building fo�whid�the
application is made,the owner or corrtractor 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 shail be notlfied. It shall be unla�aful 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 suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water service airb stop box or the sewer lead at the property line or a water service le�d has
been extended to the property line for wnnection,the appticant,owner,or occuparrt or user of such premises shall be Ifable for all repairs
required to any water line and sewer lines r�ecessary for conrtection of the premises from the mairt to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged fo�the c.osts of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as wiii ensure that it remains above the ftnished
grade of the land or property. (Ref 538,1156,1191j