Meter Swap , • Request Number: 14430
Public Works Division
Service Request
Problem Address: 5234 Fillmore St Requested By: Chris Hoffer
Depsrtment: WA1ER Addreas: No address pcovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-SZ2-8369
ScLeduled 2017-04-12 Schedaled 1lmc: 10:30:00
. � �
AC'IiON NEEDED:
Crexted by: Beth Kondrick Date Cresited: 2017-03-30
ACTION TAI�N:
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5tatus: In Progress Sabmitter Has Been r
Coutacted
Da�te Completed: Completed by:
Honrs f �Q�
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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 empioyees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and ali iMerlor
piumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,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 READING( Id meter) _ � v� � �O
Name• �� Y'� ��`� Address_ �L l7� � �1��"� � 1
Phone Number �� �e_�, ' 1�-" `�
Signature �/ \ �— Witness Signature
OLD METER# ��C� ✓��
OLD READING �Z� 1 �v
NEW METER# � � �� ��
NEW READING �
ERT# � ���� � � �
FRiDLEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any haise or buiiding for which the
application is made,the owner or contractor shall be requi�ed to obtain a permit for wch wnnection,and shall paq a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shall be unlawfut to cover
any connecting line uMil an inspedion 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 connection,the applicant,owner,or occupant or user of such premises shall be IiaWe for all repairs
required to any wates line and sewer lines necessary for wnnection 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 maiMenance andJor
repairs,including necessary street repairs at a rate set annually by an administrative poticy. It shall be the responsibility of the appficarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dear[ng or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains abrnre the flnished
grade of the tand or property. (Ref 638,3156,1191)