Meter Swap � ° Request Number: 14512
Public Works Division
Service Request
Problem Address: 5380 6th St Requested By: Patricia Siedlecld
Department: WATER Address: No a�ress provided _
Problem/Issne: 1NSTALL AMR METER Phone Number: 763-572-8075
5cheduled Date: 2017-04-18 Schednled'Ilme: 11:00:00
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AC'IION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-04
ACTTON TAI�N: � ��
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
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� City of Fridley S��`�'� ��-
Water Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 alsa hold the City of Fridiey andJits emplayees harmtess for any damages that may oaur while doir�this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. 1�undersWnd t am also reguired
to obtain a permit prior to any work,if necessary.
FIMAL METER READIMG(oid meter) � �� ��4
Name:��\ � ,�� Address �� �
Phone Number � � ��� VDate �,` � ��
Signature Witness Signature
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156t 1191�
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer tine connecting the existing municipal system and arry house or buitding for whid�the
application is made,the owner or contractor shali 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 notified. It shall be unlawful to cover
any connecting line until 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 CONNECTfON
After the initial connection has been made to the water service curb stop box or the sewer lead at the property{ine or a water service fead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water tine and sewer lines necessary for connection of the premises from the main to the premises. If the property oarner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant o�user to perform standard maintenance of the sewer service line from the premises to the main including debMs clearing or
�oot cutting and to maintain the water service curb stop box for operebility and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)