Meter Swap .- Request Number: 14980
Public Works Division
Service Request
Problem Address: 5435 4th St Requested By: Jemufer Giguere
DepnrtmeM: WA1ER Addres�. No a�ress provided
Problem/isene: IN5TALL AMR ME1ER Phone Nnmber: 612-247-7639
�
Scbedaled Date• 2017-OS-OS Schednied'Ilme: 10:00:00
� �� f�Q,�.,
ACTION NEEDED:
Crexted by: Beth Kon�ick Date Created: 201'7-04-26
ACTION TAI�N:
�..�.s�.c(�'
Status: In Progxess Sabmitter Aas Beeu r.,
Coukacted
D�te Completed: �_�^ (� Completed by: � � -
� a �
a
�f,��
�
w,
:� .�
, ��o - ��
� `� �5�
- �n a��
City of Fridley �/ �
Water Department � ��(�
6431 University Avenue NE
Fridfey,MN 55432
763-572-3566
�/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 ir�terior
plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for arry damages that may oacur while doing this
operation. This to incfude,but not limited to valves,piping,walis,floors or the curb stop box and senrice line. 1�understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �����D
Wame: r 31.������ �f 9GlU� Address '��!�� �� � .
Phone Number �� y �L(� I `� �� " i Date _ �� �+ � t
Signature Witness Signature ��
OLD METER# _ ��l �� 1,�
OLD READ{NG v ( ( L v D
NEW METER# �� �� � � O �
NEW READING �
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)
$02.5 PERMIT FEE
Prior to construcCing or repair of any water of sewer Ilne connecting the existing municipal system and arry house or building for whkh the
application is made,the owner or contractor 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 tse notifted. It shafl be unlawful to cover
any wnnecting 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 APID MAINTENANCE TO CONNECTION
Afte�the initial cannection has been made to the water service curb stop box or the sewer lead at the property line or a water�rvice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shali be tiable for all repairs
required to any water line and sewer lines necessary fw connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be per�ormed by the City,the property owner shail be charged for the cos�of tfie mair�tenance and/or
repairs,including necessary street repairs at a rate set annuatly by an administrative po{icy. It shali 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 including debris clearing or
root cutting and to mairrtain the water service curb stop box for operebility and at such height as will ensure that tt remains above the finished
grade of the land or property. (Ref 638,1156,1191�