Meter Swap � <
Request Number: 14649
Public Works Division
Service Request
Problem Address: 5427 4th St Requested By: John
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-951-3207
Scheduied Date: 2017-04-19 Sche uled 15me: 01:00:00
l�� 4a
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-12
ACTION TAI�N:
� `�
„
� �
._.............��.___._.. ....__.___._........ ..........._. ... ............ _..............__..................._........_....................._..................._..........__.._._................................_...._._...........__._..............._.�...
�__-
Status: In Progress Submitter Has Been �
Contacted
Date Completed: Completed by:
�..) ,� � � . 1,,1 � �Or
�
���� �� � �
� - � � -- u �
� ��
City of Frid(ey
S� � �
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/W►e hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the maln to the premise and all iMerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmiess for any damages that may ocar while doing this
operation. This to include,but not limited to valves,piping.walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any wo�lc,if necessary.
FlNAt METER READtNG(old meter) V � I � ��
Name:��� Address v'�1�� �� �
Phone Number��CJ iJ'�� �����Date �� t �� V�
Signature Witness Signature
OLD METER# ���L��� - 1
OLD READING � I c� 1 't�
NEW METER# � `"I�� �1 b�
NEW READING �
ERT#_ � �� ( � � � 1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAPIITARY 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 arry water of sewer line wnnecting the existing municipai system and ar�y house or buiiding for which the
application is made,the owner or cor�tractor shall be required to obtain a permit for such wnnection,and shall pay a permit fee as provided io
Chapter 11 of this Code. After such connection has been made,the Water and Sewer DepartmeM 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 properry line or a water service kad has
been extended to the property line for connection,the applicar�t,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water line and sewer Ifnes necessary for connection of the premises from the main to the premises. If the properly owner
requests maiMenance service or repairs be performed by the City,the property owner shall be ch�rged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set anrtuaily by an administrative poliry. It shai!be the responsibility of the applicaM,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the qremises to the main i�cluding deb�is clearing 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)