Meter Swap �
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Request Number: 14777
Public Works Division
Seryice Request
Problem Addresa: 4964 Roman Rd Requested By: Allen Swanson
Departmeat: WATER Addreas: No acl�ess provided
ProMem/Iasue: INSTALL AMR ME1ER Fhone Number: 572-8766
Sc6edul d e: 2 17-04-26 � Scheduted 1lme: 01:00:00
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ACII�ON 1�iEEDED:
Creat��by: Wendy Hiatt Date Created: 201'7-i14-19
AC'fION'�'r�N:
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Status: In Pro�ess Sabmitter Has Been r
Co�rtactei
DAte Completcd: ��1 r_,.`'� Completed by: ��k,�
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City of Fridley �� � �� � �
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridiey 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 irnerior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its empioyees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) 1 v" 1��`��
Name: ��1�1�. ��� Address � � `-"� � 42-I1'h�� � •
Pho�e Number ���� " {�11Y� Date � J " ""✓��
Signature Wkness Signature
OLD METER# �(,B/ /�!✓���
4LD READING_ v�� �� "�v
NEW METER# t 1 �� "���
NEW READING v
ERT# ` ��� � I"'�
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 buildtng for which the
application is made,the owner or wntractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it 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 sen�ce lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable fa�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 maintenance and/or
repairs,includi�g necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main induding debris clea�ing or
root cutting and to mairrtain the water seroice curb stop box for operabil'ity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
Request Number: 9537
Public Works Division
Service Request
Problem Address: 4964 Roman Rd Requested By: A1 Swanson
Department: WATER Address: No address provided
Problem/Issue: TURN WATER ONlOFF Phone Number: 572-876b
Scheduled Date: 2014-11-24 Scheduled Time: 02:30:00
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ACTION NEEDED:Emergency water shut off
Created by: Wendy Hiatt �ate Created: 2014-11-24
ACTION TAI�N:
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Status: In Progress Resident Contacted �
Date Completed: Completed by:
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