Meter Swap ��
� Request Number: 16474
Public works Division
Service Request
Problem Address: 4761 Main St Requested By: Richard
Department: WA1ER Address: No address provided �'
Problem/Issue: INSTALL AMR METER Phone Nudrbe�:� 763-574-9433
5cheduled Date: 201�� �� Scheduled 13me: 07:00:00
. �
ACTION NEEDED:
Created by: � Beth Kondrick Date Created: 2017-07-26
ACTION TAI�N:
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Status: In Progress Submitter Has Been r. . �
Contacted
Date Completed: •--1 �� � �� Completed by: � �
_` 0�. �P
,
'►t �iityy��Frae9ley
j �ater Depart�reea�t /ti�, � (��`7���''Q�
fs431 l7niversoty Avenue 1VE I W `�� l�
Fridley,MIV 55432 �m�� ��
763-572-3566 �� ��
!/we hereby authorize the City of Fridley artd/or its emPloyees to do aahat is necessary to
rep4ace the water meter. 1 understand that the property�nrner is liable for the water line from the main to#he premise and all interior
plumbing. (Per C'�ty code�02.06) 9 also hold the City of Fridley and/�ts employees haranless for arry damages that may occur while doing this
operatian> This to include,but not limited to vsives,pipin�walis,floors or the curb stop box and service line, in understand l am also require
to abtain a permit prior to arsy�vortc,if necessary.
FlPIAI METER REAptNiG{oid meterj �� � �� " �
Piame: L�``CJ'w��(� Address_ � 1 VG � M.G,�� .J'�' •
Phone Numbec 1 �� ^ ��- 1–' /" (✓�pate l " � �— ��
�( Signature�c3�� � Witness Signature "r�
o�o M�,-ER# __ ��a i� �
OLD READlN�S v vv `� ���
NEWMETER# �� 35 ��a S
NEIeV RfADNVG V
ERT# � (/" 6� �v''� ,�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMIMISTRATION
(Ref Ord No 113,4f�,565,566,629,638,662,9�2,988,11�4,1156,119i)
402.5 PERMIT FEE
Prior to consCruding or repair ofi arry water of sewer tine conoecting the existing municipal system a�d any house or buiiding for whic6 the
appiication is made,the owner or corttractor sha(1 be required to obtain a permit for such connecCion,and shat[pay a permit fee as provtded in
Chapter 1I of this+Code. After such connection has been made,the Water and Sewer Department shai[be notified. tt shall be unlawful to cover
any connecting line until an inspectSort has been made and such connection and the work incident thereto has been approved by the Ctty as a
proper and suitabfe rnnnection.
402A6 REPAIRS AND MAINTENANCE TO COPINELTIOlU
After the i�itial connectson has been made ta tfie water service curb stop box or the sewer lead at the property line or a water serviae tead has
been extended to the property line for connection,the applicarrt,owner,or occuparrt ar user of such premises shali be iiable for alt repairs
required to any water line and sewer lines necessary#or connection of the premises from the main to the p�emises, tf the properiy owner
requests mairrtenance service or repairs be perFormed by the�ty,the property oarner shall be charged for the wsts of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shal!be the respo�ibility of the applicarrt,
owner,occupant or user to perform standard maintenance af the sewer sQrvice line from the premises to the main intluding debris clearing or
root cutting and to maintain the water senrice curb stop hox for operability and at such height as will ensure that it remains above the finished
grade af the tand or property. (Ref 638,1156,1191'
� _ / D/�� �J- -
�j �y��s�u��+
City of Fridley �
Water Department
Address �� � �/ � � ,�t, J��
Name �j t-�,�,�el �,�; �1 c
� �
Date �—' �-- �l �
Old Meter Number ���
Old Meter Reading ��- U
, �
Replacement No. � �� �I`
Replacement Reading �
Replacement Make ,�� ���.�-
Remarks• ,f�,�,r,.e f �'Y.�t-�t�-
Signed
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