Meter Swap � � Request Number: 14490
Public Works Division
Service Request
Problem Address: 548 54th A�e Requested By: Stacy
Departme�: WA1ER Address: No address provided
Probte�/Issr�: IIVSTALL AMR ME1ER Phoae Nnmber: 763-238-2759
Scheduled Date: 2017-04-10 Scheduled 1Ime: 11:30:00
,r1.� ,� I�.
ACiTON NEEDED:
Created by: Beth Kondrick Date Crcated: 2017-04-03
ACITON TAKEN: �
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Status: In Progress Submitter Hns Been r
Contsuted
Date Completed: Cos�pleted by:
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City of Fridley
Water Department
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. I understand that the property owner is liable for the water line from the main to the premise and ali interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocau 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 1 am also required
to obtain a permit prior to arry work,if necessary.
FINAL METER READING(old meter) I � �� LI l,/
Name• Address � `� ��� �'"`�•►'�.�
Phooe Number �p! )`���~ ���ate � � y�� ��
Signature Witness Signature
OLD METER# I� U-I
OtD READING � � ��""���/
NEW METER# — F� I�.J� -1 V�
NEW READING O
ERT# ������
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Plo 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to wnstructing or repaFr of any water of sewer line�nnecting the existing municlpal system and arry house or bullding for whicb the
application is made,the owner or wntrador shall be required to obtain a permit for wch connection,and shall pay a permit fee�provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shall be unla�aful 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 CONNECTION
After the initial connection has been made to the water senrice wrb stop box or the sewe�lead at the property fine or a water se�vice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water tine 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 properly owner shall be charged for the wsts of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility af the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main includir�debris dearing or
root cutting and to maintain the water service 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)