Meter Swap 'f. : � �
� Request Number: 15190
Public works Division
Service Request
Problem Address: 224 Panorama Are Requested By: Samuel
Departme�: WATER Address: No address provided
Problem/tssue: INSTALL AMR METER Phone Number: 952-297-4430
Schednled D�te: 2017-OS-20 Schednled 1lme: 08:00:00
G�,� v lC�. ' 0..�'
AClION NEEDED:
Crented by: Wendy Hiatt Ihte Created: 2017-OS-08
ACTION TAI�N:
Statua: In Progress Sabmitter Hu Been �
Contacted
Date Compieted: Com�eted by:
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City of Fridley � � I ��
Water Department �
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We � , hereby authorize the City of Fridiey and/or its employees to do what is necessary to
�replace the water meter. 1 understand that the p y 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 t o�'Fridiey 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 Iine. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � •���
Name• �� ` �, Address�`T
Phone Number��Z'"�1 1" �'!�[�V pate��`�r ��
Slgt�ature��/�..""+►_-.�+--r ' /�� Witness Signature
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OLD METER# �, i~ �������� ����`
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DLD READING ���• �Ot"E'O (`,, - -� ����'"'r�
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NEr�nn�'ER# ' 49225968
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NEW READING �
ERT#_ IIIIIIIIIIIIIIIIIIIIII E
�� 1 72355'195
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)
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer line wnnecting the existing municipal system and any house or building for whFch the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shatl pay a permitfee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. 1t 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 senrice tead has
bee�extended to the property line for connection,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 service or repairs be performed by the City,the property owner shail be charged for the costs of the maiMenance and/or .:
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shail 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 dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,3191)
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