Meter Swap ..
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Request Number: 14520
Public works Division
Service Request
Problem Address: 5370 4th St Requested By: Bormie
Department: WA1ER Address: No address provided
Problem/Isaue: INSTALL AMR ME1ER Phone Number: 763-586-0550
Sche ed Date• 2 7-04-10 Schedaled 11�e: 08:30:U0
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AGTION NEEDED:
Created by: Wemly Hiatt Date Cresued: 2017-04-OS
ACTION TAI�N:
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Stxtus: 1n Progress Sabmitter Ha�Been �.,
CoMacted
Dxte Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
UWe hereby authorize the City of Fridley and/or its empfoyees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water Ilne 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 ocar while dang this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. in undentand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �� D � �
Name:���� Address J��� �� � `
Phone Number `Y/�� ���~���te � � V� � v `
Signature Witness Signature
OLD METER#_� � �� y”! �
OLD READING � �� � ` � � '
NEW METER# —{ 2� � O� ��w J �
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NEW READING �
ERT# 4 �Z� ��J�� .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMIN ISTRATI ON
(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 building for which the
appiication is made,the owner or corrtractor shall be required to obtain a permit for wch 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�ver
any connecting line until an inspection has been made and wch 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 service lead has
been extended to the property line fo�connection,the appiicant,owner,or occupaM or user of wcfi premises shall be liabie for aN 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 shall be charged for the costs of the maintenance and/or
repairs,including 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 maiMenance 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 finished
grade of the land or property. (Ref 638,1156,1191)