Meter Swap Request Number: 14958
Public works Division
Service Request
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��dress: 4603 Main St Requested By: Teresa Renstrom
_�artment: WATER Address: No address provided
-�'� Problem/Tasue: 1NSTALL AMR ME'IEK Phone Number: 5'71-5323
Schednled Date: 2017-OS-06 Scheduled TYme: 07:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2Q17-04-26
ACTION TAI�N:
Status: In Progress Snbmitter Has Beea r
ContActed
Date Compteted: Completed by:
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City of Fridley �� � ����
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�lwe hereby authorize the C'rty of Fridley and/or its empioyees to do what is necessary 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 Fridiey and/its employees harmless for any damages that may ocwr while doing this
operation. This to include,but not limited to vaives,piping,walls,floors or the curb stop 6ox 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• �'�J✓'�!I� `�=►-�Q'lil�- Address_`��lP b��l ��,{,�1ti ��
Phone Number �� �1 '��'!,�_ Date �
._____..�._�
Signature Witness Signature
OLD METER# /��l ��C��
OLD READiNG �C'��� j�
NEW METER�
NEW READIN4 4'5907133
ERT#_ IIIIlI IIIII{IIIII IIIII E
1 1 7'I 8'I 2640
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
4U2.5 PERMfT FEE
Prior to construding 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 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 aad Sewer Department shali be not'�fied. tt sfiall be un{awfu{to cover
any connecting tine 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 REPAfRS 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 lead has
been extended to the property line for connection,the applipnt,owner,or occupant or user of such premises shall be liabie for all repairs ,
required to any water line and sewer lines necessary for connection 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 shall be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annuaity by an administrative polky. It shall be the responsibility of the applicant,
owner,occupant 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 such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)