Meter Swap �
� Request Number: 14834
Public works Division
Service Request
Problem Address: 5025 Hughes Av�e Requested By: Mrs Ronald Zemba
Depxrtment: WATER Address: No a�ress provided
Problem/Issue: INSTALL AMR METER Phone Nnmber: 572-9268
Scheduled Date: 2017-04-24 Schednled 13me: 01:30:00
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ACTION NEEDED:
Created by: Wendy+Hiatt D�te Created: 2017-04-ZO
ACTION TAI�N:
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Statns: In Progress Submitter H�Been r,
Co�acted
Date Completed: Completed by:
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City of Fridley � �
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
repiace the water meter. 1 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 occur while doir�this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)_ ��� � ��
Name:���, ���iW�,�E�, Address
Phone Number_ '7��� `-� � Date �`�—\` � `
Signature v \� / Witness Signature
OLD METER# 1�t0�����
OLD READING I �� I � L- �
NEW METER# �a 2b �2� �
NEW READING_l/'
ERT# � ��Z� � p�
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 arn house or buiiding for whi�the
application is made,the owner or wr�tractor 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 conrtection has been made.the Water and Sewer Department slwll be notjfied. It shali be unlawful to c.over
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 line or a water serWce lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be I'�able for all repairs
required to any water line and sewer lines necessary for connectlon of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shail be charged for the costs ot 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 applicarit,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main indudir�g debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wi(I enwre that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)