Meter Swap l •
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Rubli� YV�rks Division
S��vi�� Requ�st
Frol�lem A�drtss: 6365 Stf�St Reqt�t�t�By: To�-Maa�gef hx Village
(3e�een Apts
DepRrt�E: WA1'ER Addrees:
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�r . INSTAL.L AMIt M�TER F'�N�nber: 612-668-3252
s�a,�.a n.�: �1-�o'►� sa�.ant.�'r�me: g ;p�a.n�
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�r�a���1 iy: - �aty Er�ahd: 2017-1i-07
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Statn�: - Snbmitter Contacte�: falae
Date�ompleted: Completed By:
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City of Fridley
Water Department � ���D,v�
6431 University Avenue NE � �
Fridley,MN 55432 G (�
763-572-3566 �b � ✓�� t/
1/we hereby authorize the�ty of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable fo�the water line from the main to the premise and all iMerio�
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and servtce line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAI METER READING(old meter)
Name: Address �3G5 ��AS�" ���i�'e- G.e�.,�, /�o�c
Phone Number Date �d ��✓ � �
Signature Witness Signature /�si�—. �1 _ �!
OLD METER# �� /� 1 ��y SIZE & STYLE ICircle)
OLD READING 3��/ ���-dv 5/8" HEX
NEW METER# �1�y9 yar�o 1" HEX
NEW READING � �4" ELIPTICAL or EX
ERT# 7aC�1�t YS � i�� ELIPTICAL or��'wEx
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMtNISTRA►TION
(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
application is made,the owner or wrrtractor sha11 be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 31 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspedion has been made and such connection and the work incident thereto has been approved by the C�ty as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINTENANCE T�CQNNECTION
After the initial connection has been made to the water service wrb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property line for connedion,the applicant,owner,or oaupant or user of such premises shall be liable for all repairs
required to arry 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 shail be charged for the costs of the ma�ritenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the respoosibility of the applicant,
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 maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished �
grade of the land or property. (Ref 638,1156,1191)