Meter Swap �
� Request Number: 15160
Public Works Division
Service Request
Problem Address: Z00 Panorama Ave Requested By: Bernadette Pogreba
Department: WATER Address: No adc�ess provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-498•4165
Schednled D�te: 2017-OS-06 Scheduled'Rme: 01:00:00
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ACITON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-OS-OS
ACTION TAi�N:
5tatus: In Progress Sabmitter Has Been �,.,
Contacted
Date Completed: Completed by:
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City of Fridley �� � �/� !�
Water Department ��
6431 University Avenue NE
Fridiey,MN 55432
763-57Z-3566
�/We hereby authorize the City of Fridley and/or its employees 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 interior
plumbing. (Per City code 402.06) !also hold the City of Fridiey and/its employees harmless for any damages that may occur while doing this
operation. 7his to intlude,but not limited to valves,piping,wa!!s,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) ` ���V `E/�
Name: J� �b�-! Address_ � {Ji�"�"' �^� ��
Phone Plumber �0 1� � Date ����� �
Signature W�tness Signature��
OLD METER# c��✓v���Q�S
OLD READING l Z�`S `°'�J
NEW METER# �
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NEW READING � 48907175
E�# IIIIIIIIIIIIIIIIIIIIII E �
'1 1 718'12655
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 any water of sewer line connecting the existing municipal system and any house or building for whkh!he
application is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Departmerrt sball be notified. It shalt be unlawful to cover
any connecting li�e until an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AIMD MAINTENANCE TO CONNECflON
After the initial connection has been made to the water servlce curb stop box or the sewer lead at the property line or a water service lead has
been extended to the properly line for connection,the applicant,owner,or occupant or user of seich premises shal!be liable for all repairs
required to any water tine and sewer tines necessary for connection of the premises from the main to the premises. !f the properry owner
requests maintenance service or repairs be perFormed by the City,the property owner shali be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the appiipnt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing o�
root cutting and to maintain the water senrice curb stop box for operability and at such height as wiil ensure that it remains above the flnished
grade of the land or property. (Ref 638,1156,1191)
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� City of Fridley
Water Department
Address �DO �C1�nQ�GNi.�
Name IJQr r�L,4're �Q �p� r� �q
Date � � � � t� �Q�
Old Meter Number �� S � � � l
Old Meter Reading � I � 7 7�
Replacement No: �0 � ���
Replacement Reading �
Replacement Make a�, �'-P
Remarks• � 1� �.� �
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Signe
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