Meter Swap 1
�' Request Number: 16434
Public Works Division
Service Request
Problem Address: 6241 Trinity Dr Requested By: Dillon
Department: WATER Address: No address provided
Problem/Issue: INSTAL,L AMR METER Phone Number:
Scheduled Date: 2 17-0 -26 � Schedaled 1lme: 11:30:00
C.l �
ACTION NEEDED:
Created by: Wendy Hiatt Dxte Created: 2017-07-24
ACITON TAI�N:
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Status: In Progress Submitter Haa Been r �
Contacted
Date Completed: Completed by:
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City o#Fridley � C�� � � �(�
• Water Department /
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
��`"�e hereby authorize the City of Fridtey and/or its emptoyees to do what is aeaessary to
rep�ace the water meter. t understand that the property owner is liable for the water line from the main to the premise and a!t interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley andPts employees harmless for any damages that may occur while doing this
operation. This to include,but not limited ta valves,piping,walis,floors orthe aub stop box and service line. in undentand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL M R READING ol ������ �
( d meterj
Name: r����... Address �' Y1�� �
Pfi ne �r Date _ 4 —�� 1+ 1
Signatur Witness Signature ���
Ol.D METER# �Q F �����
OLD READ{NG ��� ��� �
NEW METER# � t �� �� " l �
NEW READING�
ERT# �� ` 1 � � ��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATION
(Ref Ord'No 113,464,565,566,629,638,662,422,988,1144,1156,1191j
4Q2.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line co�necting the existing municipal system and any house or building for which the
application is made,the owner or car�tractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this tade. After such connection has been made,the Water and Sewer Departmerrt shalt be notified. {t sha{I be unl,awfui to cover
any connecting line until an inspection has been made aad such wnnection and the work incident thereto has been approved by the Cliy 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 hox or the sewer lead at the property line or a water s�nrice(ead has
been extended to the property line for connection,the applicant.owner,or occupar�t or user of sucf�premises shall be tiabie tor ail repairs
required to any water line and sewer(ines necessary for connection of the premises from the main to the premises. tf the properly owner
requests maintenance service or repairs be performed by the�ty,the property owner shall he charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an admi�istrative policy. It shall be tfie responsibifity of the applicar�t,
owner,occupant or user to perform standard maintenance aE tl�e sewer service line from the premises to the main including debris clearing ar
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)
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" �� City of Fridley
Water Department
Address �p�-y� �r'`'1 i�
Name C�alr�rlCe 1''��.�a�
Date � � �` ����O
Old Meter Number � � � ! '
Old Meter Reading � � � O d
Replaeement No. � S d O
Replacement Reading �
Replacement Make����
Remarks� r�►d rn�
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Signe
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