Meter Swap �
' Request Number: 15223
Public Works Division
Service Request
Problem Address: 4941 Roman Rd � Requested By: Rola�Pogreba
Departmemt: WATER Addresa: No address provided
Problem/issue: INSTALL AMR METER Phose Number: 572-8691
Scheduled Date: 2017- 5-09 Sc�edaled 11me: 11:30:00
� ..� i ,
ACIION NEEDED:
Crented by: Wendy Hiatt Date Created: 2017-OS-08
ACTION TAi�N:
�5���� -�6�-
Status: In Progress ��her Hac Bcen r,
Co��ted
Date Campleted: �` �_ �� Completedby: �a��
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i City of Fridley �� � �D��
Water Department
6431 University Avenue NE
Fridtey, MN 55432
763-572-3566
�/We hereby autho�ize the City of Frtdley 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 premtse and ali interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees Narmless for any damages that may oaur while doing this
operation. This to include,but not limited to valves,piping,walis,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.
F1N/U.METER READIPlG(old meterj � `�' �� "
Name: �1� Address �� � I ��"�Q,h t'�%`
Phone Number ���� �"' � ' Date � � ( '— � 1
Signature Witness Signature `��
OLD METER# `='�� �v� �
OLD READING �� 1 ��v
NEW METER# y 1�� V���
NEW READING �
ERT#_ � �O�I �� 1�
FRfDLEY CtTY 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 construding or repair of any water of sewer line wnnecting the existing municipal system and any house or building for which the
application is made,the owner or contrador shall be required to obtain a permit for such co��ection,and shall pay a perm(t fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notif'ied. R 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 witable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water service curb stop box or the sewer lead at the property line or a water serv�lead has
been extended to the property line for connection,the applicant,owner,or occuparrt or user of wch premises shall be liabie for all repairs
required to any water line and sewer lines necessary forconnection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the C"ity,the property owner shafl be charged for the�of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicaM,
owner,occupant or user to perform standa�d mairrtenance of the sewer service line from the premises to the main including debris dearing o�
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 638,1156,1191)