Meter Swap '" ` s,�
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Request Number: 14458
Public works Division
Service Request
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Problem Address: 1360 53rd Ave Requested By: Clair Tettemeir
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nwnber: 763-571-7687
Scheduled Date: 2017-04-06 heduled'Iime: 11:00:00
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��TION NEEDED:
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�'ated by: Beth Kondrick Date Created: 2017-03-31
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ACTION T.�II�Ns '�
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Statns: In Progress Submitter Has Been G
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�. Date Completed: � --� — `� Completed by: ��� t
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-5723566
�/We hereby authorize t6e�ty 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 line from the main to the premise and ali i�rterior
plumbing. (Per City code 402.06) I also hold the City of Fridley andrts employees harmless for any damages that may ouvr 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) C/ "�D V �O
Name:_l.il��4 r �� ��'i�/11l' l� Address ( J�� ��r� �•
Phone Number /lY J✓ � / 1 v��K./ 1 Date �✓ `��� � �
S7gnature Witness Signature
OLD METER# ��������
OLD READING cJ�7 v� �v
NEW METER# ( {�d L ��
NEW REQDING �
ERT#_ ��d�d��� L I
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref O�d No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water af sewer line connecting the existing municipal system and amr house or building for whkh the
application is made,the owner or contractor shall be required to obtain a permit for such�nnection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notified. It shali be unlawful to corer
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 senrice lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shaii be liable fa ali repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff 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 poliq. It shall be the responsibility of the appli�M,
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 seroice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)