Meter Swap �
� Request Number: 14424
Public Works Division
Service Request
Problem Address: 538 Cheri Circle Requeated By: Ron Hayman
Department:', WA'IER Addresa: No address provided
Problem/Lcs�e: INSTALL AMR METER Phone Number: 763-807-2236
Scheduled Date: 2017-04-04 Scheduled 1lme: 07:30:00
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ACITON NEEDED:
Created by: Beth Konclrick Date Created: 2017-03-30
ACTION TAKEN:
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Status: InProg�ess Snbmitter Has Been r,
Contacted
Date Completed: Completed by:
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City of Fridley �� �j-3�f 3
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
I/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 frnm the main to the premis�and ali interior
plumbtng. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the wrb stop box and s�rvice line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) L � �� ���
Name•�D� �Q�,J�,N'ZQ„f1 Address � ✓� l/''`•�i� l�1/�"
Phone Number�C✓�C�I.J` f���� Date_ `�L��' I�
Signature Witness Signature
OLD METER# ��� ��� �
OLD READING r 1 ��� vV
NEW METER# '�l�� �J� ��
NEW READING �
ERT# � ��� � �� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building 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 provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspedion has been made and such connection and the work inudent thereto has been approved by!he C[ty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial wnnection has been made to the water senrice curb stop box or the sewer lead at the property line or a water senrke lead has
been extended to the property line for connection,the applicant,owne�,or occupant or user of wch premises shall be liable for ail repairs
required to any water line and sewer lines�ecessary for connection of the premises from the main to the premises. ff the propert�►owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,i�cluding�ecessary street repairs at a rate set annually by an administrative poliry. k shall be the responsibifity of ihe applicaM,
owner,occupant or user to perform standard maintenance of the sewer service lioe from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)