Meter Swap � � Request Number: 14532
Public Works Division
Service Request
Problem Address: 1470 Glacier Ln Requested By: Larry Beckle
Depu-tment: WATER Address: No address provided
Problem/Isaue: INSTALL AMIt METER Phone Number: 763-574-2129
Schedoled Date: 2Q 17-04-I 1 Schednled 1lme: 01:30:00
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ACIION NEEDED:
Created by: Beth Kondrick Date Cres�ted: 2017-04-OS
ACTION TAI�N:
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���; ��o�ss Snbmitter Has Beee �,
Co�s�cted
Dnte Completed: Completed by:
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City of Fridley � 2���/
Water Department � `, 7
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
IJwe hereby authorize the City of Fridley andJor its empfoyees to do what is necessary to
replace the wate�meter. I understand that the properiy owner is fiable for the water line from the main to the premise and all Interior
plumbing. (Per C'�tyr code 402.06) 1 aiso hold the City of Fridiey and/its employees harmless for any damages that may occur whife doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service tine. in understand I am also required
to obtain a pe�mit prior to any work,i�necessary.
FtNAI METER READING old metery � r �I � ��
Name: Address__ Y��V V�'�� l�+'�
Phone Number !Y✓C7� � �`{�'���v bate '�1�� ' �`�
Signature �tness Signature
OLD METER# � �"� ` �� �
OLD READING ��l�' � �V
NEW METER# ����'� 1
NEW READING V
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 vf s�wer line connecting the existing municipai system an�l any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made.the Water and Sewer Departmerrt shal{be notified. It shall be unlawfui to wver
any connecting line untii an inspection has been made and such connection and the work incident thereto has been approved by the Ctty as a
proper a�d witable connection.
402.06 REPAIRS AND MAiNTENANCE TO CONNECTION
After the initial connection fias been made to the water service curb stop box or the sewer lead at the prope�ty line or a water serv�e tead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises sfiall be liable for ail repairs
required to any water line and sewer lines necessary for connection af the premises from the main to the premises. If the properly owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the wsts of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administ�ative policy. It shail be the responsibility of the applip�t,
owner,occupant or user to perfo�m standard maintenance of tfie sewer service line from the premises to the main including debris clearing or
root cutting and to mai�ain the water service curb stop box for operability and at such height as wtll ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)