Meter Swap �
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Gil}+O,j
Ftidley
Request Number: 17599
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Problem A�ress: 4977 Rom�Rd Ae�aeatad�y: l�ste
Depnrtme�t: WA1Fdt Ad�ress: No ad�ess providsd
� Prablcm/Lsee: INSTALL AMR ME1ER P6oee N�etber: 7�63-439-1382
ScLe ed D�be: 2018-01•24 � Sc6edoled 13me: 09:00:0(f
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� Cre�e�by: Wendy Hiatt Date Created: 2'018-01-19
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� City of Fridley
Water Department
6431 University Avenue NE
Fridfey,MN 55432
763-572-3566
1/we hereby authorize the C'�ty of Fridley and/or its employees to do what(s necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and aN iMerior
plumbing. (Per City code 402.06) I also hold the City of Fridley and�ts employees harmless for a�y 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 senrice line. In understand 1 am alw required
to obtain a permit prior to any work,ff necessary.
FINAL METER READING(old meter) 1��f � / �
Name• 1 V�. Address �� L I ��n�,� 1�[.�
PhoneNumber� �� �� / v�w Date � ^ ��— � V
� Signature Witness Signature �'
.�.-�-
OLD METER# � � �� �(J�� SIZE & STYLE(Circlel
OLD READING �cJ� I ��� 5��� 5/ HEX
C�
NEW METER# 1� v ! �/ ��� -I 1" HEX
NEW READING O i�4" ELIPTICAL or HEX
ERT# � l 8�. i a a 3 2" ELIPTICAL or HEX
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 PERMR FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buildir�for which the�
application is made,the owner or contractor shall be required to obtain a permit for wch connedion,and shali pay a pertnit fee aa provid�d in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Departmerrt 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 approv�d by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC110N
After the initial wnnection has been made to the water service curb stop box or the sewer lead at the property line or a wate�senriae lead has
been extended to the property line for connection,the applicant,owner,or ocwpant or user o�'such premises sha!!be liabie for all repairs
required to any water line and sewer lines necessary for 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 maiMenance and/or
repairs,including necessary street repairs at a rete set annually by an administrative poliry. It shall be the responsibility of the applicaM,
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 638,1156,1191)