Meter Swap r
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. -�`���f1�f���`« Request Number: 2� �
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Publl� Works �ivision
� S�rviE� Requ�st .
Prubl�n Addt�s: 6329 S�t►St Reque�ted l�y: Tom-Man�eF l�Or Vitlage
Grsen Apts
Djep�u�eut; WAT�E Address:
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P�abk�e: It`�3'PAL.i.AMR I4I�'T�R F�ene N�b�: 612-666-3252
3chedWed H�be: 3�dnl�d Thne:
�(7"Y'"1 ��-��L ��t31�
ACTIOI�t 1'�E�I�De AM11
Enat�i iy: - Da�� �nat�d: 2027-1i-�7
�"1'"IAN TA��N� '' '
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statas: - Snbmittcr contnc�ed: false
Data Compieted: Cwnpleted Hy:
Hours:
v�a ��„ i7 1����. ,� /�r�..
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City of Fridley s�� �6 O`�
Water Department
6431 University Avenue NE
Fridley,MN 55432 �a�4rc�l�yv-��
763-572-3566
1/we hereby authorize the�ty of Fridley and/or its employees to do what ts necessary to
replace the water meter. I understand that the properly owner is liable for the water li�e from the main to the premise and all irrterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may o�r while doing this
operation. This to include,but not limited to valves,piping,walis�floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)
Name: Address 4� 3 ��� S�� ,�,� V. ���hC ��ta�..��
Phone Number Date
� i"��. 17
Signature Witness Signature �' 7'-=y'�_. __.
....... .
OLD METER# �7� `-� 3 �5 i rl SIZE & STYLE(Circlel
OLD READING ����`` �� 5/8" HEX
NEW METER# 4�y� �I c�C•r l 1" HEX
NEW READING � 134' ELIPTICAL or EX
z�
ERT# 7��y I �G� 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,i191j
402.5 PERMIT FEE
Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or bu1lding for whkh the
application is made,the owner or wntractor 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 connectio�has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line uMil 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 bas been made to the water service curb stop box or the sewer lead at the property line or a water�nrice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of wch premises shall be lisble for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the p'operty 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 annual�y by an admintstrative poliry. It shatt be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris 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)