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Meter Swap Request Number: 14323 Public Works Division Service Request Problem A,ddress: 1358 66th Ave Requested By: Dahlmeier Department: WA1ER Address: No address provided Problem/Ias�: INSTALL AMR ME1F.R Phone Number: 763-572-2371 � Sc6eduled Dxte: 2017-04-03 Sc6edaled 1lme: i0;0U:00 � �� ACTION NEEDED: Created by: Beth I�ondrick Date Created: 2017-03-2? ACTION TAI�N: � � �%a.1_ll� � ` v Stah�s: InProgress Snbmitter Has Been �.. CoMacted Date Completed: Completed by: .. ��'�Y �� � �� , ��5 � � 6� � �� �c� I � City of Fridley �(/ � � !�� Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 ��We hereby authorize the C'ity of Fridley and/or its employees to do what is necessary to replace the water meter, t understand that the properly owner is liable for the water line from the main to the premise and all intertor plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for arry 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 understand 1 am also required to obtain a permit prior to any work,if necessary. FINAI METER READiNG(old meter) � `'�� 1 Name:�Y�,�����y Address ���c.J �� ' '�v�` Phone Number�� ��� � """ �� � � � Date_r � Signature V Witness Signature OLD METER# ���� ��� OLD READING � �`� � �D� NEW METER# `''F�D KJ 2��V NEW READING v ERT# �� l J Z I �p� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connectiog the existing municipal system and any house or building for whic�the application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permk fee as provtded in Chapter ii of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notified. It shail be unlawful to cover any wnnecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the C�as a proper and suifable connection. 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 lesd has been extended to the property line for connection,the applicant,owner,or ocwpant or user of such premises shall be Ilabk 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�rner requests maintenance service 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 poliry. It shall be the responsibility ofi the applipM, 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 for operability and at such heigM as will ensure that i!remains above the fr�ished grade of the land or property. (Ref 638,1156,1191)