Meter Swap a
` Request Number: 14822
Public Works Division
Service Request
Problem Address: 540 53 1/2 A�ne Requested By: Gary Walen
Department: WA1ER Address: No address provi�d
Problem/Issue: INSTALL AMR METER Phone Number: 763-572-9030
Schednled Date: 2017-04-26 5chednled'Rme: 09:00:00
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ACIION NEEDED:
CreAted by: Beth Kondrick Date Crexted: 20I 7-04-20
ACTION T .
! �.s � 12
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Status: 1n Progress Sabtn�tter Has Beea r,
Contacted
Date Completed: Completed by:
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City of Fridley ����'�
Water Department S(��
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
I/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 Iine from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may o�r while doing this
operation. This to include,but not limited to valves,piping,walis,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) � �I �'� v
Name: � V v a� Address_ �`�1,O �� �2 �l�/—
Phone Number � �C/����� /�./�e � �� Y (
Signature Wkness Signature���/ � �
OLD METER# � � � � � 1 � �
OLD READING I 2 � � ���
NEW METER# __ �� �J4.J � ��y'
NEW READING �
E�# �122 2 �2 2�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATIOPI
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
A02.5 PERMIT FEE
Prior to constructing 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 wrrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter il 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 a�inspedion has been made and such connection and the work incident thereto has been approved by the City as a
proper and witable connedion.
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 service lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the properly owner
requests maintenance service o�repai�s be performed by the City,the property owner sfiafl 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 applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the mai�including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remaios above the finished
grade of the land or property. (Ref 638,1156,1191)
Request for Service Repart
� �it�r of Fridley
R eference N o: 601-11-3263 D ate: 08101!11
Requesk Type= Install AMR meter Enkered By: Wendy Hiatt
Department: Water Citizen tJame: Gary Walen
Address= 540 53 1I2 AVE NE Callback Phane: 763-572-903Q
Scheduled Date= 08104J71 10:00 AM�J� Property Owner:
Location Details: Request Details= Change old meter
Action Taken:
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Responsible Person:
Approver.
Completion Date: �� � � Citizen Notified
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