Meter Swap Request Number: 16034
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Public Works Divisian
Service Req�est
Problem Address: 1604 Briardale Rd Requested By: 51ah
Departmeut: WA1ER Address: No address provided
ProblemlLssue: INSTALL AMR METER Phone Nnmber: 763-586-0944
Sc6edul Date: 2017-06-19 ---� Schednled�me: 01:00:00
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ACTION NEEDED:
Created by�: Wendy Hiatt Date Created: 2017-06-16
AC7ION TAI�1�1:
_.__�_���..............���;��__.-�---�----------_.._
Status: In Progress Submitter Has Been �..
Contacted
Date Completed: Completed by: ��*
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• City of Fridley � � ��.��
; Water Departrnent
fi431 University Avenue NE
Fridiey,MN 55432
763-572-3566
�r`"�e hereby authortze the City of Fridley and/or its empioyees to do what is necessary to
replace the water metec. t understand that the property owner is liable for the water line from the main to the premise and afi interior
piumbing. (Per City cade 402.06) 1 also hold the C'fij of Frid{ey and/its employees harmiess for any damages that may occur while doing this
operation. This to include,but not timited to valres,piping,walts,floors or the curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIPIG(oid meterJ �� `" � ��
Name• ��GLY� Address I�v� �'n�_�l,{'� �
PhoneNumber tIG��"���� `��"� Date _ `O� 9"V���
� Sig�ature Witness Signatuse
OLD METER# eJ�'�'�-'�.! �� rZ�
OLD READING 0��� ��}C�
NEW MfTER# � t 1�����
NEW READING O
��# � 22Z�2�o
FRIDLEY CiTY CODE
CHAPTER 402.WATER,S�'ORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord IVo 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or bui{ding for which the
application is made,the owner or contractor shall be requ'sred 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 Departmerit shall be notified. It shall be u�lawful to cover
any connecting tine unti!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 APID MP,tAiTET1AAlCE TO CONNECTION
After the initial connection has been made to the water servtce curb stop box or the sewer lead at the property line rn a water servic�e Iead has
been extended to the property line for connedion,the appficarrt,owner,or occupant or user af such premises shall be I�ab{e for afl repairs
required to any water line and sewer lines necessary for conneetion of the premises from the main to the premises. lf the property owner
requests maintenance service or repairs be perFormed by the City,the property owner shafl be ch�rged for the costs of the maiMenan�and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be tfie responsibility af the appliqnt,
owner,occupant or user to perform standard maintenance ot the sewer service line from the premises to the main including debris dearing or
root cutting and to mairitain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finish+ed
grade af the land or property. (Ref 638,1156,1191)
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D�-r��
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City of Fridley
Wat_ er De��artment
Address (��`JL� �21 ��� ��
Name ��� ����v�l
Date � ' `r�
Old Meter Number 1 1 � �� r'—J---
Old Meter Reading ��� I ��
Replacement No. �/���
Replacement Reading }� --
Replacement Make ����
Remarks: �_a�P� �� -
S igned "�
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