Meter Swap ,
y Request Number: 15110
Pub�c works Division
Service Request
Problem Address: 532 53 1/2 A�e Requested By: Cheryl Davis
DepartmeM: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR ME7ER Phone Number: 763-280-3817
Scheduled Date: 2017-OS-08 Sc6ednled 1lme: 08:00:00
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ACTION NEEDED:
Created by: Beth Kandrick Date Created: 2017-OS-02
ACITON T.�I�N:
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Status: In Progress �bmitter Has Been �..,
Co�acted
Date Completed: Completed by:
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City of Fridley
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. I understand that the property owner is tiable for the water line from the main to the premise and all inte�ior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing thls
operation. This to include,but not{imited to valves,piping,walis,fioors or the curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,ff necessary.
FINAL METER READING(old meter) J��� �
Name: ��,�_, Address U� � L, l� �-�" ' `�
Phone Number� (,)�'� � �1�ate �� �_ 1�
Signature _ � ��i' Witness Signature �
OLD METER# �� O� ����
OLD READING � E�� ��v
NEW METER# '" 1� 1'� � �� �
NEW READING �
ERT# 1 � ��� ( �Z
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,56f,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building f�which 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 ii of this Code. After such 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 CONNERION
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 fine for connection,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. if the property a�rner
requests maintenance serv�ce or repairs be perFormed by the Ctty,the property owner shali be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rete set annually by an administrative poliry. It shall be the responsibility of the app4icant,
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 service curb stop box fo�operability and at such height as will ensure tfiat it remains above the finished
grade of the land or property. (Ref 638,1156,1191)