Meter Swap i
� _ _ Request Number: 16369
Public works Division
Service Reqaest
Probiem A�ddress: 6181 Benjamin St Requested By: Michaela
Department: WATER Address: No address psovided
ProMem/Issue: INSTALL AMR METER Phone Number: 1-218-684-4863
Scheduled Dat • 2017-0 -2� � Scheduled 1ime: 10:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-07-18
ACTION TAI�N:
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:k Status: In Pro�ess Submitter Has Been r.
,
Contacted
Date Completed: "'� �. Z""]�f� Completed by: \ ��
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, �,�r���r��tey
, water�Depart►r,ee�� ��/ �j/ ';'�
fi431 lJrsiversity Avenue 1VE
Fristl�y,MN 5543�
?63-572-3566
!/we hereby authorize the City of F�dtey andfo�its employees to da what is necessary to
replace the water meter. 1 understand that the property owner is liable for tt►e water line from the main to the premise and all inte�or
ptumbing. (Per�City code 402.06) !a(so hold t6e City of Fridley andjits employees harmless for arry damages that may occur while doing this
operation. '9'his to include,but not limited to valves,piping,walts,#loors or the curb stop boz and senrice line. In understand t am aiso requi�
to obtain a permit prior to anY work,if necessary.
FIRIAL METER READING{oId mete�) `� � � � � `�'
Name• ►Vl[Lh�,�l� Address ` �/ � � �Q1. �{� ��-
Phorte�lumber 1'� �O ���� �11�3 pate � �, l -- �
�S� nature �`�
�� Witrtess Signatq�re
o�D M�-�R#_ � � � 1 � � '�
OL� READING _ V CJ� l VO ';
PiEW METER# 1 1 �l ✓ I J�
NEW' READING �
ERT# �oC �/ �S!�
FRlDIEY CITY CODE ';
CHAPTER 402.WATER,ST�RM WATER A�11D SANITARY SEWER
AOMlNISTRATtON'
4ltef Ord Plo 113,464,565,566,629,635,662,�22,988,1144,1156,1191j
402.5 PERMlT FEE
� Prior to constructing or repair of am�water of sQwer line wnnecting the existirig muhicipal system and arry house or buifding for which the
application is made,the owner or contractor shail be required to obtain a permit for such con�ection,and shall pay a permit fee as provided in
Chapter 11 af tEtiis Code. After sach conneceion has been made,the Water and Sewer pepartmerrt s6a11 be notified. Pt shalt be unlawfui to cover
any connecting line urrtii an inspedion has been made and such connection and the war(c incident thereto has been approved by the Crty as a
proper and suitabte connection.
402.06 REPAIRS AND MAtIVTEAiANCE TO COAfNECTiON
After the tnitia4 connection has been rr�ade to the water service curb stop box or tf�e s�wer(ead at the property line or a water s�nrice lead has
been extended to the property line for connection,the applicarre,owner,or occuparrt o�user of such premises shal{be tiabie for aii repairs
required to any water line and sewer tines necessary for connecCiort of the premises from the main to the premises. If the propertyt owner
requests mairrtenance service or repairs qe performed by the C'rty,the property owner shall be charged for the casts of the mairrtenance and/or
;;,,, repairs,including necessary street repairs at a a�ate set annuaily by an administrative policy. It shall be the responsibility af the applicarrC,
1 owner,occupant or user to perForm standard maintenance of the sewer service line frc�m the premises to the main induding debris clearing or
root cutting and to maimain the�vater service curb stop box for operability and at such height as wiil ensure that it remains above the�nished
grade af the land or property. (Ref 638,1156,1191�