Meter Swap .�
�' Request Number: 15125
Public works Division
Service Request
_ �.
Problem Address: 4639 Main St Requested By: John
Depxrtme�: WATER Address: No address provided
Problem/Issue: INSTALI,AMR METER Phone Number: 763-572-9385
Sc6eduled Date: 2017-OS-22 Sc�ednled 13me: 11:00:00
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ACTION NEEDED:
Create�by: Beth Kondrick D�Ee Cra�ed: 201'7-OS-03
AC'IION TAI�N:
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5tatus: In Progress Snbmitter Hna Been r,
i Cout�ted
Date Completed: , 1 � '� Completed by: � � (, �
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� City of Fridley �� f��
Water Department � �
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/�e hereby authorize the City of Fridiey and/or its employees 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 all interior
piumbing. (Per City code 402.06) 1 also hold the City of Fridfey and/its employees harmless for any damages that may occur while doing this
operation. This to inciude,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(ofd meter) �i' �4� �� �
Name• � B�'� Address �� � b �(d���� 5� •
Phone Number ���� � `�" I 3�J Date J "! � d�'� �' (
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Signature Witness Signature
OLD METER# � v� /v �
OLD READING ������ l V
NEW METER# ������ `t
NEW READtNG �
ERT# �� J� L 1� 1
FRIDLEY CITY CODE �
CHAPTER 402.WATER,STORM WATER AND SANfTARY SEWER
ADMINISTRATION
(Ref Ord No 113,454,565,565,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to coostructing c�repair of any water of sewer line connecting the existing municipai system and any house or buiidtng for which the
application is made,the owner or co�rtractor 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 notif'ied. It shail be unlawfuf to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by tfie 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 properly line or a water service lead has
been extended to tfie praperty line for wnnection,the applicant,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 senrice or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annuapy by an administrative poliry. ft shall be the responsibil'�ty of the applicant,
owner,occupant or user to perform standard maiirte�aace 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 fo�operability and at such height as wii!ensure that it remairrs above the finished
grade of the land or property. (Ref 638,1156,1191�