Meter Swap 4 Request Number: 14252
Public Works Division
Service Request
Problem Addresa: 6620 Channel Rd Requested By: Mr Keeney
Departme�: WA'IER Address: No�ddreas provided
Problem/Is:�: INSTALL AMR METER Phone Number: 1-608-412-0458
Sche e 1ate: 2017-03-29 5tred�led T1me: 07:00:00
� / Y I
AG"IION NEEDED:
Created by: Wendy Hi�t Dhtte Created: 201?-03-22
ACTI�N TAI�N:
�5�.��` ���
St�ua: In Progress Submitter Ha Be�n �
Cont�ted
IMte Completed: Comideted by:
2J'Z�-- �� -�-� �,Or'
l
� � �'�,k� � �=�����' ���
City of Fridley �,'�� i
Water Department -��'' � l ��
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
��We hereby authorize the C'ity of Fridiey andJor its employees to do what is ne�ssary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all i�erior
plumbing. (Per City tode 402.06) 1 also hoid the City of Fridley and/'Ks employees harmless for any damages that may oaur while dang this
operation. This to tnciude,but not limited to valves,piping,walls,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 READtNG(old meter) � ��� `-�' �
Name: 1 ��f ���VL(� Address �K� i–�J l��' �.�`,Y�QJ\ �
PhoneNumber bViwJr 6`I�.�v 1 J� Date ����— `�
Signature Witness Signature
OLDMETER#_ ` rJ J��✓�v/ �
�`'` /' /�'� s�.����l ( •
OLD READING r� �J ZbLJ
NEW METER#
���D �� �� � ��
NEW READING �
ERT# � �' � � �S ��
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 PERMR FEE
Prior to construct(ng or repair of any water of sewer line connecting the existing muntcipal system and any house or�ilding for which the
application is made,the owner or contrador shall be required to obtain a permit for such connection,and shall pay a permit fee as pro�rided in
Chapter li of this Code. After such connection has 6een made,the Water and Sewer Department shall be notified. It shafl be uniawful to cover
any connecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial con�ection has been made to the water service curb stop box or the sewer tead at the property line or a water service lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of wch premises shall be liable for ail 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 maintenance service or repairs be performed by the City,the property owner shall be charged for tfie costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main includPng debris dearing 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 the land or property. (Ref 638,1156,1191)