Meter Swap �
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Request Number: 1�12
Public Works Division
Service Request
Problem Address: 125 Pilot Av�e Requested By: Paul Baker
Depsu�tment: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR ME'IER Phoae Numbcr: 612-845-3631
Scheduled Date: 2017-OS-15 Sc6ednled 11me: 10:00:00
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ACTION NEEDED:
C`reAted by: We�y Hiatt Date Created: 2U 17-OS-08
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ACIION TAi�N:
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St�us: Ir►Pro ess Snbmitter Has B�ea r
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Date Completed: [ ^ (�` �� Completed by: �G��,�
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Ci of Fridle � �v' v
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Water Department �� � �/I�I
6431 University Avenue NE �.���
Fridley, MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its smployees 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) 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,watis,floors or the curb stop box and service line. In understand 1 am also requlred
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)
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Name: ��^'� �G,�� Address �""J \ � l�� T—�� �--
Phone Number ��1'�' � L�" �� ' Date �~ �� � � l
Signature Witness Signature
OLD METER# `��� ����v
OLD READING �����a �
NEW METER# ���� ` ��
NEW READING O
ERT# � I � � I� `�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,6Z9,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the exist�ng municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provFded in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shali be unlawful to cover
any conneding line until an inspection has been made and such connection and the work incident thereto has been a�roved 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 lead has
been 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 fo�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 annually by an administrative poliry. It shail be the responsibility of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including 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�nished
grade of the land or property. (Ref 638,3156,1191)
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