Meter Swap � . � Request Number: 14291
Pu1n�c Works Division
Service Request
Problem Address: 6683 Anoka St Requested By: Charlene
Department: WATER Address: No address provided
Problem/Issue: INSTAL,L AMR METER Phone Nwnber: 571-7245
Scheduled Date: 2017-03-31 Schednled'I'Ime: 01:00:00
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AC'IION NEEDED:
Created by: Wendy Hiatt Date Created: 201�-03-24
ACTION T.4I�N:
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Status: In Progress Submitter Has Been r
Cout�ted
I�te Compieted: Compteted by:
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� � City of Fridley
Water Department
6431 University Avenue NE �� _ (����� .�r
Fridiey,MN 55432 � � �
763-572-3566 2��--
�/We hereby authorize the City of Fridiey and/or its empjoyees to do what is necessary to
replace the water meter. l understand that the property owner is liable for the water line from the main to the premise and alt interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may oaur 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 I am also required
to obtain a permit prior to any worlc,if necessary.
FINAL METER READING(old meter) � � � � ���
Name: l_/��'r L�/r �� Address C7't�/�� ��/L, �
Phone Number �� ���� 1� Date ��� `J `�
Signature _ ���� �--� Witneu Signature
OLD METER# � � xU� � I l��
OLD READING � � � �� �O
NEW METER# I � �� ��'O�
NEW READING �
ERT# � 1 �"�— 1 �—��
FRi���r cinr cou�
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 tonstructing or repair of arry water of sewer line connecting the existing municipal system and ariy house or building for which the
appiication is made,the owner or cor�tractor shal{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�otified. It shall be unlawful to�ver
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 witable 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 properly 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 shatl be liable for all repairs
required to any water line 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 C'ity,the property owner shall be charged for the costs of the malntenance and/or
repairs,including necessary street repairs at a rate set annually bY an administrative poliry. It shall be the responsibility af the app{iprrt,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main includirig debris clearing 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 638,3156,1191)
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City of Fridley
Water Department
Address E7 p � � ��1�k� ��
Name F�-��� �C�r��y
Date � r��,�d�
Old Meter Number �-� t���
Qld Meter Readin 7 3`� � l �
Replacement Na � �� � �
Replacement Reading V'
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ReplacementMake ff.,� '�-1'�
RT
Remarks:
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