Meter Swap ,
�' Request Number: 15579
Public Works Division
Service Request
Problem Address: 1353 Hillcrest Dr Requested By: Josh Larson
Department: WA1ER Address: No a�dchess provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-308-9734
ScLeduled DAte: 2017-OS-31 Schednl ed'ISme: 11:30:00
l S� � r 3�
ACTION NEEDED:
Cre�ted by: Wendy Hiatt Date Created: 2U17-OS-26
AC'ITON TAKEN: � ���
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Status: Tn Progress Suhmitter Aaa Been r.
Contacted
Date Completed: Completed by:
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+ �City ofi Fridtey 2j� -� �7��� ��3
� Water Department
6431 llniversity Avenue PIE C� � � //��
Fridley,MN 55432 J �f
763-572-3566
��VNe hereby authorize the Crty of Fridiey and/or its employees to do what is necessary ta
reptace the water meter. 1 understand that the property awner is liable for the water line from the main to the premise and all iriterior
piumbing. (Per City code 402.�6} 1 also hald the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand i am also required
to abtain a permit prior to any work,if necessary.
FINA!METER READING(old meter) �� �� ��O
Name:_���� �..f�V1�� Address _ � �?�� `����� ��
Phone Number ����� p� �'3� �� '
�Signature Witness Signature
OLD METER# � � ��� - I ��
OLD READING �� D�� ���
NEW METER# �Z--� I��
PIEW READING `.J
ERT# ��i��� ��CJ v
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANtTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191}
402.5 PERMiT FEE
Prior to constructing o�repair of any water of sewer line connecting the existi�g municipai system and any house or building for which the
application is made,the owner or contractor shaft be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such wnnedion has been made,the Water and Sewer Department shait be notified. It shaii be untaarFul te coder
any connecting tine until an inspection has been made and such connection and the work inciderrC thereto has been approved by the City as a•
proper and suitable connection.
402.06 REPAfRS AAID MAfN'i'ENANCE TO CONNEC770N
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 servtce lead has
been extended to the property line for connection,the applicant,owner,ar occuparrt or user of such premises shaU be Itable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. tE the pro{�rty owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarrt,
owner,occupant or user to perfvrm standard mairrtenance of the sewer senrice line f�om the premises to the main including debris clearing or
root cutting and#o maintain the water service curb stop box for operabitity and at such height as wiil ensure that it remai�s above the finished
grade of the land or property. (Ref 638,1156,1191)