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Meter Swap � f Request Number: 14977 Public Works Division Service Request Problem Addresa: 509 53 1/2 Ave Requested By: Chanthara Phorrthipsavath Department: WATER Address: No address provided Problem/Issne: INSTALL AMR ME1ER Phone Number: 763-232-1592 Schednled Date: 2017-OS-02 5c�eduled 11me: 08:00:00 �— r� ACIION NEEDED: Created by: Beth Kondrick Date Creited: 2017-04-26 ACTION TAI�N: ._._. .__l_ 1� 1���. Statua: In Progress Sabmitter Has Beea r, Contncted Date Completed: Completed by: �' 2- �� �l lo r � i ��� " � l �{/� k� l �� � � w City of Fridley Water De artrnent O � �� �� P 6431 University Avenue NE Fridley,MN 55432 763-572-3566 �/We hereby authorize the City of Fridley and/or its employees to do what a ne�ssary to replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and ali irKertor plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for arry damages that may occur while doing this operation. This to include,but not limited to vaives,piping,walis,floors or the wrb stop box and service line. In understand 1 am also required to obtain a permit prior to any work,if necessary. • F1NAL METER READING(old meter) ��� � �� Name• s _ J� l�� `/�L— ' �" _ Phone Number�� �,��� �� �/T_�ate �_�� 1� Signature Witr�ess Signature OLD METER# � v����✓ OLD READING �� �� I�� NEW METER#_" �d��4� I �� � NEW READING D E�# � Igl �I �� I FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,9$8,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or butiding for which the application is made,the owner or corrtrador 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 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 i�cident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial co�nection has been made to the water service curb stop box or the sewer lead at the property line or a water ser+�ice lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liabie for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premfses. If the properly owner requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance and/or repairs,including necessary street repairs at a rate set annually 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 induding debris clearing or root cutting and to maintain the water service curb stop box for operebility and at such height as wiil ensure that it remains above the finished grade of the land or property. (Ref 638,1156,3191)