Meter Swap Request Number: 14359
Public Warks Division
Service Request
. __ _ _
ess: 1601 Berne Rd Requested By: Tom Mattson
Iie�..._ WATER Address: No address provided
Problem/issue: INSTALL AMR METER Phone Number: 612-306-2111
Scheduled Dgte: 2017-04-04 Scheduled TYme: 07:00:00
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AC7ION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-03-28
AGIION TAI�N:
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Status: In Progress Sabmitter Has Been r,
Co��ted
D�#e Completed: �,.J,,_�f�'� Completed by: � �
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+ City of Fridley
S��- 33�J I
Water Department
6431 University Avenue NE
Fridtey,MN 55432
763-572-3566
���e hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all i�rterior
plumbing. (Per City code 402.06] I also hold the City of Fridley and/its employees harmless for any damages that may o�r while doing this
operation. This to include,but not 17mited to valves,piptng,walls,floors or the wrb stop box and serviae line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj `�' �o�i�' v �O
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Name: (�4Y►- 1��Q�-{-�O✓! Address ��[�/� �7�i�Vl� � .
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Phone Number `"��2� �"�'���'�'� Date ���^� 1
Signature Witness Signature �
OtD METER# V O I I � �Q�`' -
OLD READING �V��V � `�
NEW METER# y��O � i f V
NEW READING �
E�# "� aa�3 � �a
FF�IDLEY CITY CODE
CNAPTER 402.WATER,STORM WATER AND SANtTARY S�WER
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�nnecting the existing municipal system andl any house or buitdina for whid�the
application is made,the owner or contractor shall be required to obtain a permit for such connection,gnd shatl pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shalt be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such wnnection and the work incident thereto has been appro�d by the City as a
proper and witable wnnection.
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 Iine or a wate�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 any 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 tbe City,the property owner shall be charged fo�the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaUy by an administrative policy. R shall be the responsibil'rty of the applipirt,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premiseS to the main induding 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)