Meter Swap . �
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Request Number: 16484
Public Works Division
Service Request
Problem Address: 6594 Fridiey St Requested By: Kirsten
Department: WATER Address: No�dress provided
�,., Problem/Issue: INSTALL AMR METER Phone Number: 763-360-5480
Scheduled e: 2 17-07-28 %� Scheduled'Iime: 08:30:00
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AC�TON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-07-27
ACTION T�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completefi'� Completed by: 1 ��
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` �nra�e����a����� $� � �j�1�-�'7
6431 l�niversity Aarenue NE
Frisll�y,MIV 55432
763-5?2-3566
il�''Ye hereby authorize the�ty af FrPdtey and/or its emp(oyees to do what is necessary to
replace the water meter. t understand that the property owner is liable far the water line from the main to the premise and a{I iriterior
plurnbing. �Per City code 402.06) 1 also hold the City of Fridley and/its employees harmtess#or arry damages that may occur while doing this
operation. '!'his to include,but noi limited to va(ves,piping,wa{is,floors or the curb stop box and service line. In understand!am also requirE
to obtain a permit prior to any wor&,if necessary.
FINAL METER READIiUG{old meter} v✓ 3� v / �
Name: ��r�`e� Address V1 5 �"� J�I� I�. � �J T +
` Phone Nu b ��" lf/U� 1 VODate � ` � � ��
�Signatu Witness Signature
Ol.D METER# � `�`G�� � � �
oLD R�D��G v � 3�c�7 0
NEW METER# � 9 3� 5 � j o
NEIA/ READING �
ERT# � a �� 5a��o
FRIDLEY CBTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRAT{ON
�Itef Orc(No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE �
� Prior#o�onstructing ar reRair of a+ry water af sewrer line connecting the existing municipal system artd arry house or bui(din�for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
�hapter 11 of this Code. After such connection has been made,the Water and Sewer Department shalt be notified. It shall be unlavuful to wvec
any connecting line until an inspection has been made and such connection and the work inciderrt tfiereto has beert approved by the Crty as a
proper and suitable con�ection.
402.06 REPAIRS AND MAINTENANCE TO COPlNECTION
Aftee the initiai connectio�has been made to the water service curb stop box or the sewer lead at the property line or a water senrice dead has
been extended to the property line for connection,the applicarrt,owner,or occupant ar user of wch premises shall he liabte for all repairs
required to any water line artd sewer(ines necessary for connection of the premises from the main to the premises. If the property orvner
requests mairrtenaace service or repairs be performed by the Crty,the property owner shall be charged for the costs of the mair�tenance and/o�
repaers,including necessary street repa�rs at a rate set annaally by an admirtistrative policy. It shaU be the resportsibiltty of the applicarrt,
owner,occupant or user to perform standarsl mairrtenance of the sewer service line from the premises to the main including debris clearing or
roofi cutting and+to mairrtain the+aater service curb stop Box for operability and at such height as will ensure that it remains above the finished
grade af fihe land ar property. (Ref 638,1156,1191)
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City of Fridley
Water Det�artment
Address IL�-�J 1� ����7 ,�� �
Name
Date -' "�
Old Meter Number � � ���
Old Meter Readin �J� ��_.___
Replacement No. �� _
� Replacement Reading �
Replacement Make <��
�G
Remarks:��.�.u`'��7� J t��T�
S igned � ��
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