Meter Swap - �� Request Number: 14345
Public works Division
Service Request
Problem Address: 1451 Glacier Ln Requested By: Hugo Wolf
Dep�rtment: WA'IER Addreas: No address provisi�d
Problemllss�: INSTAL,L AMR METER Pha�Number: 571-4069
Sc6eduled�e: 201?-04-04 Se6ednied Ttme: I 1:00:00
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Create�by: W�ady Hiatt Date Created: 2�17-03-28
AC'IION TAI�N:
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Status: In Progress 5ebmitter I�aa Been `.
Co�acted
Dxte Co�pleted: Complated by:
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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 Pridiey andJor its employees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liabte for the water line from the main to the premise and all interior
plumbing. (Per Gty code 402.06) I also hold the Cty of Fridley aad/its employees harmless for any damages that may occur while doir�this
operation. This to indude,but not limited to valves,piping,walis,floors or the curb stop box and service tine. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) Q � " � � � Q
Name:�u�� W a�,� Address_� "1�� V L VtJlkll� ��
Phone Number � l \'J ����� Date " l`_ 1 ` ��
Signature v � Witness Signature �~"�
OLD METER# ��DrO� '"t��� �
OLD READING_ ���� �� (,l
NEW METER# �� 4�� �� c��
NEW READING �
ERT# � � `� � � �`�-� �
FRIDLEY CIT1f CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,562,922,988,1144,1156,1191}
402.5 PERMIT FEE
Prior to constructing or repair of any water af sewer line connecting the existing municipal system and any house or buiiding for which the
appiiptton is made,the owner or contractor shall be required to obtain a permit for such connection,and shali pay a permR fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shalf be notified. It shall be unlawful to cover
arry conneding 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 suitabie wnnection.
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 fead has
been extended to the property tine for wnnection,the applicant,owner,or occupant or user of wch premises shall be liable for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises, fF the propeety owner
requests maintenance service or repairs be performed by the City,the property owner shail be charged for the costs of the mairrtenance and/or
repairs,including necessary street repain at a rate set annually by an administrative poliry. It shal)be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main lncluding debris dearing or
root cutCing and to mai�tain the water service curb stop box for opera6ility and at wch height as will ensure that it remains above the finished
grade of the land or property. {Ref 638,1155,1191)
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city of Fridley
Water Department
Address�� �(,�� ��cs����� ��,,.� .
Name /7�'y�� /�(�r��'�
Date S l�j .�(/
Old Meter Number l(j 7 3 Cj �''6�
Old Meter Reading �j (� ��
Replacement No. 3G'������',s
Replacement Reading �
Replacement Make ��z.,�'-
Remarks• C��l� `�it ��.�
1
Signed ��
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