Meter Swap �,
e Request Number: 15165
Public works Division
Service Request
Problem Address: 5890 Hackmann A�e Requested By: Ste�ne
Department: WATER Address: No a�ress provi�d
Probleno/Issue: INSTALL.4MRMETER PhoneNwnber: 612-919-1552
Scheduled e: 2017-0 -08 `,L Scheduled 1lme: 01:30:W
! 1'
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ACIION NEEDED:
Created by: Wendy Hiatt Date Crented: 2017-OS-05
ACTION TAI�N:
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Status: In Pro�ress 5ubmitter Has Been r,
Contacted
Date Compteted: Completed by:
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City of Fridley /'�1L ���
Water Department �����
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
I/we hereby authorize the City of Fridley and/or its employees 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 all interior
plumbing. (Per City code 402.06) f also hold the City of Fridley andjits employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,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.
FiNAI METER READING(old meter) � � 1���
Name: ���W'� Address � � �
Phone Number �1 V��� 4� r�� �-Date '-' �— f��
Signature �e/ \ Witness Signature ��
OLD METER# __ f� 1� L�� � �
OLD READING _ � 4� "\G�C� 'n�?
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NEW METER# 1� � ���� �� ��
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NEW READING O �
ERT#
�q0� 1 � � ��
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 house or building for whkh the
application is made,the owner or contrector shall be required to obtain a permit fa�such connection,and shall pay a permit fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be not�ed. It shall be unlawful to wver
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
Afte�the initial wnnection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shail be liable 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 shail be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarK,
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 finished
grade of the land or property. (Ref 638,1156,1191)