Meter Swap � ` Request Number: 14518
Public works Division
Service Request
Problem Address: 1399 66th A�e Requested By: Jaimie Debore
Department: WA'IER Address: No address provided
Problem/Isauc: INSTALL AMR ME1ER Pl�one Number: 763-432-600?
Scheduled Date: 2017-04-13 Sc6edaled 1lme: 11:00:00
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ACITON NEEDED:
Created by: Beth Kondrick Date Created: 2U 17-04-OS
A�ON TAI�N: �
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Status: In Progress Submitter Ha�Been r,
Contacted
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. 1 understand that the property owner is liable for the water line from the main to the premise and all interbr
plumbing. (Per City code 402.06) I also hoid the City of Fridley and/its employees harmless for any damages that may occur while doing ffiis
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.
FINAL METER READING(old meter) 1 ��� � "-' �✓
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Plame• m °� "�Y�x.J�c C/ Address__ � `
Phone Number / �c>^��� ���e �`�, "J` �r�
Signature Witness Signature
OLDMETER# q ��? � � `�-� �
OLD READING ( � �� � � O
NEW METER# �� � � � J,�
NEW READING �
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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 construding or repair of any water of sewer line connecting the existtng municipal system and arry house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and sfiall pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shall be not�ed. It shall be unlawFul to rnver
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 service curb stop box or the sewer lead at the property line or a water serv�lead has
been extended to ihe property line for connection,the applicant,owner,or occupant or user of such premises shall be liabte for all repairs
required to a�y water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be ch�rged for the costs of the maiMenance andJor
repairs,inciuding necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer seroice line from the premises to the main induding debris dearing or
root cutting and to maintain the water seroice curb stop box for operability and at such height as will ensure that it remains above the ftnished
grade of the land or property. (Ref 638,1156,1191)