Meter Swap Request Number: 13493
Pubtic Works Division
Service Request
Problem�dress: 5770 H�lanazm Ak: Requested By: 1�►eodore Stephenson
Department: WA1ER Address: No address p�ovided
Problem/Issae: INSTALL AMR ME'IER Phoae Nnmber: 612-600-6258
Schedilll:�,d 2017-02-24 Schedded Time: OI:OO:OU
. �T6
AG7ION NEEDED:
Cre�ed by: Wendy Hiatt D�e Created: 2017-02-1 S
AGTION TAI�,N:
�w ��,�� ��
Stx�: Tn Progress ����r H�s Been �.,
Conts�ted
Dxte Cam�teted: Completed by:
2 -2�I-- l�'j �a-I�--e-
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5431 i9nivea�sit�Aveo�ue NE
Fridleya N!N 554�2 i�
+. 753-572-3565 �� ��,
4 �/We hereby authorize#he Ciiy of Fridley and/or its employe�#o s!o what is necessary to
replace the wafier meter. 1 understand that fihe peoperty owner is tiabie for the mratee line from Yhe main to the premise and all iMerior
pluriabing. (Per Crty cosle d02.06) i also hold the C'rty af Fridley and/'rts employees harmless for any damages that may occur�rhile doing tF�is
operatian. Tfiis to include,but not limited to valves,pipin�wai(s,floors or the turl�stop box and service lis�e. In understand!am also requir
to obtain a permifi prior to any worlc,�f necessary.
oZll — `?� 7 � � 00 - � �
FlNAL METER READING(otd meter) ��� ��
Name:`1�V�i /3�l_ '�����'llrcld�ess /��� �+"—�-WIBtI'!/'� �
Phone Number�J�/��� rQ/� p� '�(��� � V�
Signature Witness Signature
OLD METER# ir 1 Z��2�
OLD READtNG ��� � i O
11iEW AAETER# t 4� "� ����
NEW READING D
ERT# � � �f ���I .
FRIDLEY C1TY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
, �Ref Ord No 113,4&4,565,566,529,638,662,922,9$8,I144,1I56,1191}
402.5 PERMiT FEE
Prior to constructing or repair of anY wate*vF sewer tine connecting the existing muniapaf system and arry f�ouse or EnriWir�for wbich the
application is made,the owrrer or corrtractor shall be required to obtain a permit for such connection,and st�all pay a permit fee as provided in•
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmertt shall be not3fied. It shail be unfawfui to cove
aray connecting line until an inspection has been made and such connection and the work inciderrt thereto 6as l�en approved by the Gty as a
proper and suitable connection.
402.06 REPAIRS ANQ lNAIAtTE1MANCE TO CONIMECTION
After the initial connectiort has been made to the water senrice curb stop box or the sewer lead at the pro�rty line or a water seniice lead has
been extended to the property line for connection,the appiicarrt,owner,or accupant or user af wch premises sf�atl be 1'�able for ali repairs
required ta any water line and sewer lines necessary for connection vF the premises from the mai�to the premises. If the property owner
requests maintenance service er repairs be performed by the City,the property owner shail be charged for the costs of ihe mairttenance and/or
repairs,induding necessary street repairs at a rate set annuai(y by an administrative policy. It sha(I be the responsibil'rty of the applicarrt,
owner,occupant or user to perForm standard mairrtenance aF the sewer service line from the premises to the main induding debris dearing or
roat cutting and to mairrtain the water service curb sfiop box for operability and at such height as wili ensure that it remains a6ove the finis(�ed
grade of the land or property. (Ref 638,1155,1191)