Meter Swap ' Request Number: 14559
Public works Division
Service Request
Problem Address: �580 53 1/2 Ave Requested By: Andrea Fawin
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 701-238-141'I
Scheduled Date: 2017-04-12 Sc6ed�11ed 1lme: 10:30:00 .
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ACTION NE'EDED: ;
Created by: Beth Kondrick Datt CreAted: 2017-04-06
AC110N TAI�N: .
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Status: In Pro ess . Submitter Has Been �,
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Date Completed: y� � Z ` l^'1 Compieted by: �
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� City of Fridley ✓� � J s ��
Water Department
6431 University Avenue NE
Fridiey,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 ail interior
plumbing. (Per City code 402.06) I also hoid the City of Fridley and�ts employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,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 meter) �J���� " �
Name: �1 �i�G. ����� Address � V 6 �� t�- ��
PhoneNumber `B�� ��v� � 1 �� Date �� lZ � ��
Signature Witness Signature
OLD METER# � �� � ���
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OLD READING �v �� ��
NEW METER# � I�� � I �v
NEW READING �-/
ERT# �. �aa ��3 �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buiiding for whkh the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shall be not�ed. 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 CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water sendce lead has
been extended to the property line for connedion,the applicaM,owner,or occupant or user of such premises shall be liable for ap repairs
required to any water line and sewer lines necessary for conneetion 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 costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility aF the applicant,
ow�er,occupant or user to perform standard maintenance of the sewer service tine from the premises to the main tnduding debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will enwre that it remains above the�nished
grade of the land o�property, (Ref 638,1156,1191)