Meter Swap ,
1 Request Number: 16073
Public Works Division
Service Request
Problem Address: 5841 6th St Requested By: Marco
Department: WATER Address: No address provi�d
Problem/Issue: INSTALL AMR METER � Phone Number: 612-481-8072
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Scheduled Date: 2017-06-27 � Schednied Time: 02:00:00
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ACTiON NEEDED:
� Creuted hy: We�xiy Hiatt Dnte Creuted: � 2017-06-21
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,�'�' ON TAKEN: .
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Status: In Progress Sabmitter Has Been r..
Coutacted
Date Completed:�j —a� �'–'7 Completed by:�
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• City of Frid#ey �" (��j2
Water Department �� [O �J�
• 6431 University Avenue NE
Fridley,MN 55432
763-572-3566
i/we hereby authorize the Gty of Fridley and(oc its employees to do what is necessary to
�eplace the water meter. f understand that the property owner is liable for the water tine from the main to the premise and alt irrterior
pfumbing. (Per C'rty code 402.06) I also hold the City of Fridley aad/its employees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to vatves,piping,waiis,floors or the curb stop box and senrice line. in understand 1 am also required
to abtain a permit pr[or to any work,if necessary.
FINAL METER READ[NG{old meterj __ � �� L t �v
Name: L"Y�v W Address � V V � �� �-
PhonelYumber V/V�`� 1 � ��� Date V�� p� V v1.�
Y.Signature Witness Signature
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OLD METER#__ �i�� ����
OLD READING � � ` 1� ��
NEW METER# � 1 �� ����
IYEW READING v
ERT# __ b ��� { 3� y
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANtTARY SEWER
ADMINISTRATiON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,i191)
402.5 PERMIT FEE
Prior to constructing or repair of arry water af sewer line connecting the exisCing municipal system and any house or building for which the
application is made,the owner or contrectov 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 shali be noti�ied. {t shaN be unlawfut to cover
any connecting line u�rti)an inspection has been made and such connection and the work incident thereto has been approved by tl�e C'rty as a
proper and suita6le connection.
402.06 REPAIRS AND MAINTENANCE TO COWNECTION
After the initiai connection has been rriade to the water senrice curb stop box or the sewer lead at the property line or a waCer service lead has
been extended to the property!'sne for connection,tfie app(icant,owner,or occuparrt or user of wch premises shall be tiab(e for all repairs
required to any water line and sewer lines necessary for connectio�of the premises from the main te the premises. tf the property owner
requests maintenance service or repairs be performed by the C'Ry,the property owner shafl be charged for the costs of the maiMenance and/o�
repairs,including necessary street repairs at a rate set annuaffy by an administrative policy. It shall 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 including clebris dearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as witl ensure that it remains above the finished
grade afi the land or property. (Ref 6.38,1156,1191)
, F�eque�t fc�r S�rvi�ee R�p€�rt
Cify�f Fridl�
��r�o: s��-i�-�a�� o��: s�z���
f�iequeat T�rp�e� Tum xatec offlor� E�er�d f3y: '4Afe�cfy}��#.
t�partment: W�� C.rtizerr t��: 'i�dr�r�ar+de�as
�� 5841 6TH ST NE ad4 Phcme: G12-d$1-�72
"Sc�eduled [3��_ P�tyUr��r:
locat+�Deta�s: Advised homec�ru�thak wva�er wcwld not be Requ�t aeta�s= Shut w�er aff_
turrted badc c��he has a penr�t.
Action T�cen:
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