Meter Swap Request Number: 14378
V Public Works Division
Service Request
ProWem Address: 6825 Channel Rd Requested By: Migel
mcsrt: WA'IER Addresa: No address providcd
m/Iasue: INSTALL AMR METER Phone Number: 763-302-9042
1 Schedul Dxte: 2011-04-05 Schednle�1lme: 10:00:(f0
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AC1iON NEEDED: \
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Crexted by: Wendy Hiatt Date Created: 2017-03-29
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Status: In Pro ss Snbmitter Has Been r, �.
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' Ds�te Completed: �1 r L ,.., �� Completed by:
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City of Fridley
• Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
. �/We hereby authorize the City of Fridley and(or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and alt inte�ior
piurnbing. (Per City.�A02.06) I also hold the City of Fridley and/its employees harmless for arry damages that may occur while doing this
operation. This to inc�de,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) ������ �
Name• �� _ Address l 5� � �
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Phone Number
Signature Witness Signature
OLD METER# q3 i �7'-�-.�
OLD READING 6`d O��J �
NEW METER# � I Z O ! ���
NEW READING �
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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)
4fl2.5 PERMIT FEE
Prior to constructing or repair af any water of sewer{ine connecting the existing municlpal system and any house or building for which tbe
application is made,the owner or contractor shall 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 shal!be notified. It shall be unlawful to cover
any conneding line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water servic�curb stop box or the sewer lead at the property line or a water ser�ice lead has
been extended to the property line for connection,the appiicar�t,owner,or occupant or user of such premises shali be{iable for all repairs
required to any water line and sewer�ines necessary for wnnection of the premises from the main to the premises. If the property ow�er
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the malntenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry, it shali be the responsibility of the appiicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearirig or
root cutting and to maintain the water service curb stop box for operability and at such height as wiN ensure tfiat it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
f2equest for�nFic�e R�p�arr#
Gity af Fridley
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