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Meter Swap 3 t Request Number: 16444 Public works Division Service Request Problem Address: 415 63rd Ave Requested By: Cheryl Department: WATER Address: No address provided Problem/Issue: INSTALL AMR METER P6one Number: 612-813-6980 Scheduled Date: 2017-08-07 Schednled'lime: 09:00:00 � � �.r� ACITON NEEDED: �:,�., Created by: Wendy Hiatt Date Created: 2017-07-24 ACTION TAi�N: __.......__.___........._�-ti��.__C l�,e� _..__��iM`�� Statas: In Progress ��ner Has Been r, Contacted Date Completed:Q �� _1`� Completed by: r � U � \� ✓ • � Cityof FridLey �"� Vy 7�'" � ( �- �� Water Department �� l/' � 6431 llniversity Avenue NE b Frodley,MN 55432 763-572-3566 ��`''�e hereby authorize the C'ity of Fridley and/or its empioyees to do what is necessary to replace the water meter. 1 understand that the property owner is liabie for the water line from the main to the premise and all irrterior plumbing. (Per Gty code 402.06) i aiso hold the City of Fridley and/its employees harmless for any damages that may ocwr while doing this operation. This to include,but not limited to valves,pipin�walls,floors or the wrb stop box and service line. In understand I am also required to abtain a permit prior to any work,if necessary. FIWAL METER READING(oid rneter) �� O Name: � Address ��r� � Phone Nu LG' ` V � �oate �~ {�� Signature WiMess Signatu� `'� OLD NiETER# �� l.�� y�zi^"'O�� . v ��°� �^�'�'�� OLD READING ��v� v�� NEW METER# t � ✓ �� l� NEW READING v ERT#_ L 0`' t ` � �lS� � FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,454,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buiiding for which the application is made,the owner or contrador shatl be required to obtain a permit for such 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 Department shail be notified. It shatl 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 CONNECT{ON After the initiat connection has been made to the water service curb stop hox or the sewer lead at the properly line or a water service iead has been extended to the property line for connection,the appficarrt,owner,or occupant or user of such premises shali be liabie for a0 repairs required to any water dine and seaver lines necessary for connection of the premises from the main to the premises. tf the property owner requests maintenance service or repairs be performed by the Crty,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 poliry. It shall be the respoosibility of the applicant, owner,occupant or user to perform standard maintenance af the sewer service line from the premises to the main including debris clearing or root cutting and#o mairrtain the water senrice curb stop 6ox 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) Ft��f�f�r�eic�: R�rt _ ' �i�y,�f � � � �: ��-�2 €��: ��o�z �� t�� : . w� ��: �� : 41� AV�t� . �� [�a�: iiequ�et Ueia�s= �. �� cQ r:.-4-- 1.� � �r.. .S�'c� �- �� '�, flr�orC �rne�-u�-. �� id �e�r# � C�Id readin�. , ��J+�w ��r# � �d�w �+�adin�, < � � E�T# � \ � �_ _____________..__._. .._ _____._____ �,�� .________. __. _.. __._.____ ___... �._.._._ � �______________ _ _______._______�___._ _ _.___.__._________�____ � �� ._ �� ...__ _�.��_ �__ � v City of Fridley Water Department 6431 Universiiy Avenue NE Fridtey,MN 55432 (763)572-3566 1/we hereby authorize the City af Fridley and/or its empioyees 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) i also hold the City of Fridley and/its employees harmless far any damages that may accur while doing this operation, This to intfude,but not limited to;valves,piping,walfs,floors or the curb � stop box and senrice line. 1 understand 1 am atso required to obtain a permit prior to any work,if necessary. Final meter reading(old meter� Name� Address: �'� � � ✓� �� Phone Number. Date: �"�� l� Signature: Witness Signature: /�lG� ''�� FRIDLEY CtTY CODE CHAPTER 4fl2.WATER,STORM WATER,AND SANITARY SEWER ADMINISTRA710N (Ref Ord No 113,464,565,566,629,638, 662,922,988,1144,1156,1191) 402.05. PERMfT FEE Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house or 6uiiding for which the application is made,the owner or cantractor shal{be required to obtain a permit for such connection,and shal)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 natified. It shalt be unlawful tQ 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 connectian. 402.06. REPAIRS AND MAINTENANCE TO CONNECTtON After the initial connection has been made to Che water service curb stop box or the sewer lead at the property line or a water service or sewer lead has been extended to the property�ine for connection,the applicant,owner, or the occupant or user of such premises shall be liable for ail repairs required to any water{ine and sewer lines necessary for connection of the premises fram the main to the premises. If the property owner requests maintenance service or repairs be perFormed by the Eity,the psoperty awne�shall be charged for the costs of the maintenance and/or repairs, inciuding any necessary st�eet repairs,at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,owner,occupant ar user to pe�form standard maintenance of the sewer service fine from the premises to the�main including debris clearing or root cutting and to maintain the water service curb stop box far operability and at such height as will ensure that it remains above the finished grade of the{and or property. (Ref 638,1156,1191)