Meter Swap Request Number: 14396
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� Public Works Division
Service Request
Problem Address: 1631 66th A�e Requested By: Brian Srnith
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 763-670-5619
Scheduied Date: 2017-04-10 Schedeled Time: 10:0U:00
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ACIION NEEDED:
Crexted by: Wexidy Hiatt Date Crented: 2017-03-29
AG7TON TAKEN: �
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Sts�us: In Progress Snbmitter Ha�Been r,
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Contacted
Date Completed: Co�pleted by: ��{�r ,
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, City of Fridley
j 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 iMerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its 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. 1�understand 1 am also required
to obtain a permit prior to any work,if necessary.
3��D �C�
FINAL METER READING�old meter) �
Name: ���^1�' ��� Address ���I �Y`� � \"" "
Phone Number �`N�� `��r "'�� Date ���� ✓� �
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Signature Witness Signature
OLD METER# �og�9���
OLD READING �� �� l�v
NEW METER# � I�� ��� ,
NEW READING �
ERT# ���a, 3� U� -'` _
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 iine wnnecting the existing municipal system and any house or building for whkh the
application is made,the owner or wntractor shall 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 shall be not�ed. k shall be unlawFui to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Citr 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 service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to a�y water line and sewer li�es necessary for connection of the premises from the maln to the premises. If the property owne�
requests mairrtenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance a�ul/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clea�ing or
root cutting and to maintain the water seroice curb stop box for operability and at such height as will ensure that it remains abov�the ftntshed
g�ade of the land or property. (Ref 638,1156,1191)