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Meter Swap � Request Number: 14578 Public works Division Service Request Problem Address: 5360 6th St Requested By: Richard Blank Depsu�tme�: WA'IER Address: No a�'ess provided Problem/7ssue: INSTAL,L AMR METER Phoee Number: 763-572-8069 SchednledD t 017- -12 Schedaled'Ilme: 01:30:00 . � , ACTYON NEF.I)ED: Crexted by: Beth Kondrick Date Cre�ed: 201?-04-�6 AC'IION TAI�N: (/Y��v 1 v`-� �� Stxtns: in Progress 5nbmitter Has Bean �., Co�acted { Date Compieted: Completed by: �f- 12_ (--� `fi'�c'� l�o�r � . 2��-� ��°� �`�� i � � �2c� City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 1/we hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. I understand that the property owner is liable for the water�ine from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City oE Fridley and/its employees harmless for arry damages that may�r while doi�this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand{am atso required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) `--� � ✓� � "�-'� Name: �� �� ` Address—�� � ��� � Phone Number��0���'�� Date `�`� �� Signature Witness Signature OLD METER# J� �� �� � J OLD READING � ( L.-�J � g� NEW METER# �- 1� ��� NEW READING � ERT# ` V21 ` �`� J FRIDLEY CiTY CODE CHAPTER 402.WATER,STORM WATER AND SANfTARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1].56,1191) 402.5 PERMIT FEE Prior to wnstructing or repair of any water of sewer line connecting the existing municipal system and any house or building for whid�the application is made,the owner or contractor 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 Department shall be not�ed. It shall be unlawful to wver any conneding lir�e until an inspection has been made and such connection and the work incident thereto has been appro�d by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connedion has been made to the water service curb stop box or the sewer lead at the property line or a water senrice kad has been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shall be liable for all repairs required to any water line and sewer lines necessary for wnnection 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 shall be charged for the c�ts of the mairttenance andjor repairs,including necessary street repaPrs at a rate set annually by an admtnistrative poliry. It shall be the responsibility of the applicam, 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 serv�ce curb stop box for operability and at wch height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)