Meter Swap ��
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� `�` Ciry of
�fiC��@y
Re�quest Number: 17310
�c�orka Divi�ioe
Servke T�e�est
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ProMa�Ad�ess: 5337�ilt�ore St Rsgne:tsd�y: Cary V�eltsr(Ctwslis�is the contaet)
Depar��t: WA1�R Addre�s: No addtEss pr�ovidsd
Probie�dIss�e: 1NSTALL,AMR 1vI�TER Fhone N�ber: 612-916-19y6
Sche�led 201'1-12-88 � Sel�edldsd'Elms: (Nl:fl8:0f? �.
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A�."I"ION NEEDED:
Created by: Wenc�+Hi�t D�e Creatsd: 2017-11 Z7
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Sab�nitter Has Baee � �{
St�us: In Progress r � : `
Cont�cted
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Date Cempteted: f Z Completed by: ��'�
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City of Fridley
Water Department �/� �,l������
6431 University Avenue NE �
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridley and/or its employees to do what is oeassary 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 iMerior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/'rts employees harmless for any damages that may oaur while doing�(s
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. in understand 1 am alw required
to obtain a permit prior to any work,if necessary. �
FINAL METER READING(old meter) ��/�� �� �� ✓"� �"' ` �
Name• ��y ����'I�Cv' Address �'V ���(J►C� ��
Phone Num r �� — 6 4 ^� / �`�Date ��` v ` ��
n�
�tgnature � Witness Signature
OLD METER# �� `� d �� � SIZE & STYLE(Circle)
OLD READING "' �� r �"�"v �,8' HEX
'� �
NEW METER# '� `� 3 5 s � a � 1" HEX
NEW READING v 1�" ELIPTICAL or HEX
ERT# 1 � �� �y I 1 2" ELIPTICAL or HEX
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 PERMIT FEE
Prior to constructing or repair of arry water of sewer line connectir�g the existing municipal system and arry house or building for which the
application is made,the owner or coMrador shall be required to obtain a permit for such connection,and shalt pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to rnver
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 suitable 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 line for wnnection,the applicant,owner,or occupant or user of such premises shall be liabk 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 maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and�or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall 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 clearing 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 flnished
grade of the land or property. (Ref 638,1156,1191)