Meter Swap �l
REQUEST FOR SERVICE REPORT
CITY OF FRIDLEY
Reference No. ��3�Z Date:
Request Type: Entered By:
Department: ��� Citizen Name: n
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Address: ���� C�r� I Phone Number: _ S 2�
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Scheduled Date: --j��S �� �12T� Property Own�"r: -
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Location Details: Request Details:
Action Taken•
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Responsible Person:
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Compfetion Date: Citizen Notified:
City of Fridley �� � ����
Water Department
6431 UniversityAvenue NE ��f" - ����d�3
Fridley,MN 55432
763-572-3566
�/We hereby authorize the�ty of Fridley and/or its employees to do what is necessary to
replace the water metea 1 understand that the property owner is liabie for the water line from the main to the premise and all iMerior
plumbing. (Per Cny code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur white doing this
operation. 7'his to include,but not limited to valves,piping,walis,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.
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FINAL METER READtNG(ald meter) v / �� � �O
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Name• �i��'��' Address lJ �� l.� I�T7 �(.,F � ;
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Phone Number (� Date r� `� �
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, � Si nature Witness Signature
OLD METER# J 3���� �� S12E & STYLE(Circlel
OLD READING � -! � / J �U 5/8" HEX
NEW METER# � [ Z � l �� ` ( 1" HE
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NEW READING l J � ELIPTICAL or HEX
ERT# �O(.t,f��`� l 5 2" ELIPTICAL or HEX
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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 PfRMIT FEE
Pr1or to wnstructing or repair of any water of sewer I(ne con�ecting the existing municipal system and any house or buiiding for which the
appiication is made,the owner or oontractor shalt 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 shali be nottfied. R shall be unlawful to cover
any conneding line until an inspection has been made and such wnnection and the work incident thereta has been approved by the City as a
proper and suitable connection.
402.� REPA{RS AND MAINTENANCE TO tONNECTION
After the initial connection has been made to the water service curb stop box or the sQwer lead at the property line or a water senrice tead has
been extended to the p�operty line for connection,the appl'icant,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 mairitenance service or repairs be performed by the City,the property owner shall be charged for the cflsts of the mairtitenance andJor
repairs,including necessary street repairs at a rate set annually by an administrative po{icy. It shali be the responsibility of the appiicant,
owner,occupant or user to pert'orm standard maintenance of the sewer service line from the premises to the main includtng debrls 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 tfie land or property. (Ref 638,1156,1191)
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