Meter Swap . Request Number: 13425
Public Works Division
Service Request
Problem Aeddress: 5779 Central A�e Requested By: Daniel Benson
Department: WATER Address: No address provicled
Problemlissue: INSTALL A�t,ME1ER Phone Numi�er: 763-586-0814
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Schednled Dxtc: 2017-02-'E4.,, Schadnled 1lme: 08:30:00
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ACTiON NEEDED:
Created by: Beth Kondrick Date Created: 201�-02-10
ACTION TAI�N:
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.�..._..___.___...._...._..._.____.._.__ �._ �
Status: In Progress �u�rter Has Beea r
Co�ted
D�e Completed: �,� 1 �,.,. ( � Completed by: � �a
� c..Y r
•rwW�,.v �y�rpe LA6A�Gf/l
5431 iDniv��sit�1�1v��s�ae NE , �� � 4
Fridley,MN 55432 � � J
� 763-572-3566 ���, �` ��"�' , L'�j � ,.�) �„
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, !/we here6y authorize the Cifiy v#Fridfey andjor its empioyees to slo what is necessary to
replace the wafier meter. I n�nderstand that the}�roperty ownQr is aiable fot the water line�rom the main to tihe premise and a!{iMerior
piumbing. (Per C�ty code 4Q2.06j i afso hofd the�'rry crf Fridfey and/'rts empioyees harm{ess for any damages that may occur white daic�g this
operatian. This to 9nclude,but not Bimd#ed to valves,pipin�walls,floors or the svria stap box and service lir�e. in understand!am elso requir
to obtairs a permit prior to arry�vor�c,�f necessary.
F!lYAL METER READiNG(old meterj � � �` � �O
lllame: J./�+Wu►�� ���N Address � l �� l/t���� �!'e .
Phone fYumber G t�� ` S 8�p.'� C}U�� Date _ �`� �"(`� r�
S�gnature ' YV�ess 5ignature �
OtD METER#_ L�����
OLD READtNG �� �� l�v
(�EW METER# �� ` V �U / �
NE11V READI�IG �
ERT# t � � � ���CJ �
FRIDLtY CiTY CODE
CHAPTER 402,WA?ER,STORM WATER AND SANITARY SEWER
AD44't1NISTRAT{ON
(Ref Orsf No 113,464,565,566,529,638,662,922,988,1144,ii56,i191)
4+02.5 AERIIAIT FEE
Prior to canstsucting or repair of any water pf sewer Pne connecting tFte existing municipal system and arry hause oc bwiidir�fvr which the
appiication is made,the vwner or corrtractor shall be required to obtain a permrt for such connection,and shall pay a penn�t fee as prpvideci in•
Chapter 11 of this Code. After suefi connection has been made,fihe Water and Sewer Departmerrt shaii be notified. it shail be untawful to c�ve
arry connecting line urrtil an tnspection has been made and such connection and the wor8c inciderrt thereto has been approved by if�e C'ity as a
proper and suitabie connectio�e.
402.06 REPAiRS A1fID 1WpffyTEfyp,p�CE TO COtltlbtECTlOt�t
After the initial cannection has been made to the xrafier service curb stop box or the sewer lead at the property liae w a water service Iead fias
been extended to i�e property line for cannection,the applir.art,owner,or r�ccuparrt or user of such premises shali be liabte for all repairs
required to a+tg water line and searer lines necessary tor connection af the premises from the main to the premises. ?�the properly o�pnec
reyuests maintenance service or repairs be performed by the C'rty,the property owner shali be charged for the sosts of ihe mairrtenance andJor
repairs,inciuding�ecessary street repairs at a rate set annuatfy by an administrattve policy. It shali be the responsibifity of the applicarrt,
owrner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main inciudir�g debris dearing or
root tutting and to mairrtain the water service curb stop box for operability and at such height as wifl ensure that it remains a6ove the finished
grade of the la�d or property. �Ref&38,1156,1191J