Meter Swap _i �' Request Number: 15135
Pubtic Works Division
Service Request
Problem Address: 4709 Main St Requested By: Keliy Lopez
Dep�rtment: WA1ER Address: No address provided
Problem/�ssue: INSTALL AMIt ME'IER Phone Nnmber: 763-951-2756
u
Scheduled Date: 2017-OS-08 Scheduled'15me: 09:00:00
� � �V'►��
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-OS-04
ACTTON TAI�N:
l �� �M, '�.,
..................�.�'��..�._..._..........._.._._._........._....._...._.....µ......_.._ . ___..._�____._._.�..__...._._.._..
Status: In Progress Sabmitter Aas Been r,
Contacted
Date Campleted: Completed by:
�J�— �J— �� � I4i�''
�
�
l t� - c� s� ��O-�0 3
` SD
' City of Fridley � �(vZ
Water Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/N+e hereby authorize the Ctty of Fridley and/or its employees to do what is necessary to
reqiace the water meter. 1 understand that the properiy owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service tiee. 1�understand 1 am also requtred
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �'�� 24
Name:r'"�./�M �t"�� Address ��,V ! � ""'"Y'�- rl�
Phone Number
������:$ � -2� � ���- �`l
Signature Witness Signature �.J `'�-�'
OLD METER# '� J �� V I �
OLD READING �I O � �
NEW METER# l l�- l. O � V 1�
NEW READING t/
ERT# ` � ������
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATtON
(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 arry house or building for which the
application is made,the owner or corrtrector 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 notjf'ied. It shall be unlawful 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 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 service fead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for aii repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. lf the propeny owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicar�t,
owner,ocwpant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris clearing or
root cutting and to maintain the water service curb stop box for operability and at wch height as will ensure tfiat it remains above the flnished
grade of the land or property. (Ref 638,1156,1191)