Meter Swap ` Request Number: 14793
Public Works Division
Service Request
Problem Address: 691 Cheri Ln l�equested By: 'lliomas Jorissen
Department: WA1ER Address: No address provi�d
Problem/Issue: INSTALL AMR ME1ER Phoec Nnmber: 763-670-4128
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��SScheduled at • 2017 4-26 Schedaled Time: 02:OO:OtI
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ACIION NEF�ED:
Created by: Wendy Hiatt Date Crerted: 2017-04-19
ACTION TAKEN:
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Status: 1n Pro ss 5nbmitter Hs�Been r �`�
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Date Completed: 'I..�_��--'`'[ Completed by: (� .
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City of Fridley ,�� �U��
Water Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the C'ity 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 all i�rterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for arry damages that may oca,�r while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb 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) 4 �� � `� �
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Name: ����'M�,G�,� �U r 155G✓t Address �-4�� �--� ��. �
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Phone Number�'_ � l� "���� Date 1�� � ' 4� '
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Signature Witness Signature
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NEW METER# t I�v �� `�'� '�``�' ,�-
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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,i191j
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipal system and any house or butlding for whkh the
applicatioo is made,the owner or contractor shall be required to obtain a permit for such connectFon,and shal!pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shall be notified. It shall be unlawFul to cover
any connecting 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 witable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property fFne for connection,the applicant,owner,or oauparrt or user of such premises shall be IiabAe for all 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 mairitenance service or repairs be performed by the C'�ty,the property owner shall be charged for the costs of the mairitenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibiltty of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wi(1 ensure that it remains above the�nished
grade of the land or property. (Ref 638,1156,1191)