Meter Swap �� Request Number: 13346
PuWic works Division
Service Request
Problem Address: 5971 Central A� Requested By: Pat Killian
DepartmeM: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-568-0042 or 932-924-6933
SchedWed D�e: 2017-02-25 Schedaled Tlme: 01:OO:Of1
ACTiON NEIDED:
Created by: Wendy Hiatt Date Created: 2017-02-08
ACIION TAI�N:
Status: In Progress 5nbmitter Ha�Been r
Co�acted
Dsite Compteted: Completed by:
2
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Wate�-�epartax�ent �
6431 lOnivea-sit�/J#ver�a�e PI� Q� ��y
Fridleya MN 55432 J /� ��
• 763-572-3566 �1"
V
� ��We hereby authorize the Ciiy of Fridley andJor its empioyees to slo what is necessary to
replace#he water meter. 1�understand that the property owner is liable for the water line from the main to the premise and al�interior
plumbing. (Per Ctty sode 402.06j i also hold the Crty af Fridley and/its employees harmless#or any damages that may occur while doing this
operation. This to include,bufi not limited to valves,piping,walis,floors or xhe curb stop box and service line. in understand I am also require�
to obtain a permit prior to any�vork,if necessary,
0�8" � �7� ?7 d - a �,
FINAL M R DIN (old ter) � �
Name: �� �� ~ Add ���
ress 1 �
Phone Number�i?P�� �� ti/ �����e �'��'^' ��
Signature . Nfitness Signature
OLD METER#_ � ` 3� �XJ�
OLD READlNC V ZO� ���_
AiEW METER#_���V �q,�1V
N�W READ{111G �
ERT# � � ci✓� ����
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATION
(Ref Ord AIo 113,464,565,566,629,638,662,922,988,1144,2156,1191}
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing muniapa(system and arry house oc building for whid�the
application is made,the owner or cor�tracto�shalt be required to obtain a permit for such connection,and shall pay a permit fee�provided in�
Chapter 11 af this Code. After such connection has been made,the Water and Sewer Departmeret shali be notif"ied. it shail be unlawful to cove+r
arry connecting line untif an inspection has been made and such connection and the work inciderrt thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAlRS AND MAtNTENANCE TO CONNECTION
After the initial connecCion has been made to the water senrice arb stop box or the sewer lead at the property line or a water service lead has
been extended to the property fine fior connection,the applicarrt,owner,or accupant or user of such premises shali 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. tf the property owner
requests maintenance service or repairs be performed try the City,the proper#y owner shail be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. R shall be the responsibil'ity of the applicant,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mai►itain the water service curb stop box for operability and at such height as will ensure that it remairis above the finished
grade af the land or praperty. (Ref 638,1156,1191)