Meter Swap .
` Request Number: 16038
Public Works Division �
Service Request
Problem Address: 5549 6th St Requested By: Puran
Depxrtment: WATER Address: No a�ress provided
Problem/Issue: INSTALL AMR METER Phone Number: 651-497-7691
ScheduledDat� 2017-06- 0 � 5cfiedNed'IIme: 01:00:00
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ACIION NEEDED:
Created bys Wendy Hiatt Date Created: 2017-06-16
ACTION TAI�N:
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Status: In Progress Submitter Has Been r,
Co�acted
Date Completed: Completed by:
Hours � q��.
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, City of Fridtey
` . ;� Water Departrnent sO � [,����
� 6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�1`^�e hereby authortze the City of Fridley and/or its employees to do what is necessary to
replace the water meter. f understand that the property owner is liable for the water line from the main to the premise and ali iMerior
plum6ing. {Per City code 402.05) f also hold the City of Fridiey andrts employees harmiess for any damages that may occx�r while doing this
operation. This to include,but not limited to vaives,piping,waffs,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj _ �� � ( ���
Name• �`)�vry` Address �� 1 """ c.1'1
Phone Number —�� �p� �'"` �1CJ'—r�
�Signature YV'nness Si�nature
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OLD METER# �b������
OLD READING v 1 f � c.� `�-�
NEW METER# r��� ��� U'
NEW READING O
ERT# � � 1�� �� l/
FR(DLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINlSTRATION
(Ref Ord No 113,464,565,566,629,638,562,921,988,1144,1156,1191)
402.5 PERMIT FEE ,
Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or buiiding for which the
application is made,the owner or contractar 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 Departmerrt shaN be notifieci. it shail be unlawful to cover
any connecting line until an inspection has been made and such connection and the woric incident thereto has been approved by the City as a
proper and suitable connection.
�02.06 REPAIRS APID MAINTENANCE TO CONNECTION -
After the initiai 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 eutended to the property line for connection,the appliwnt,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water fine 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 ch�rged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set a�nually by an administrative poliry. It shali be the responsibiliiy of the applicarit,
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 operabitity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191}
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C� a-°�f �G� ��
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City of Fridley
Water Det�artment
Address �J ��� �-�'—`�
Name � �i 1 Ar CZ
Date � � �
Old Meter Number � � � �O�_
Old Meter Reading J� l-1
Replacement No. �j� ����
Replacement Reading QS
Replacement Make `�1.��
Remarks• OL'� /1/���
Signed
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