Meter Swap � ' Request Number: 14875
Public works Division
Service Req�st
Problem Address: 572-54th Ave Requested By: Aaron Gondorchin
Department: WA1ER Address: No address provi�d
Problem/Issue: INSTALL AMR ME1ER Phone Nnmber: 612-812-4376
Scheduled Da : 2017-04-26 Sc6ednled 1lme: 11:30:00
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ACTION NEIDED:
Crented by: Beth Kondrick Date CreAted: 2017-U4-Z 1
AGTION TAI�N:
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Stahis: In Progress Snbmitter Has Been r,
Co�acted
Date Completed: Completed by:
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� City of Fridley '��
Water Department � �
6431 University Avenue NE
Fridley,MN 55432
763-5T2-3566
�1We hereby authorize the City of Fridley and/or its empfoyees 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 premtse and all imerior
plurr�bing. (Per City code 402.06) i also hoid the�ty of Fridley andrts 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 undersWnd 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL ME7ER READING(old meter) �� �D
Name: �� v �'0�'l�() Address � 1� ��� f"'�v
Phone Number �O V l�V r�� `�V�� ate � — �`�'�� V�
Signature � /1�� � Wit�ss Signature
OLD METER# �1 � �� > ������� � �� ��
OLD READING � � � y?OlJ
NEW METER# ���i��� J�
NEW READING �/
E�# � ��-� �2-23 �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND 5AN{TARY SEWER
ADMINISTRATION
(Ref Ort!No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
P�ior to constructing or repatr of any water of sewer line connecting the existi»g municipal system and any house or building for which the
application is made,the owner or corrtrector shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shall be notified. 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 witable connection.
402.06 REPAIRS AND MAiNTENANCE TO CONNECTION
After the initial connection has been made to the water service cu�b stop box or the sewer lead at the property line or a wate�service lead has
been extended to the property line for connection,the appiicant,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water line and sewer lines necessary for connectton of the premises from the main to the premises. If the property owner
requests mai�enance senrice or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. it shall be the respos►sibility of the applicant,
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 mair�tain the water service curb stop box for operability and at such height as wi8 ensure that it remains above the finished
grade of the land or property: (Ref 638,1156,1191j