Meter Swap � �" Request Number: 13568 �
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Public works Division �
Service Request
Problem Address: 1357 Hillcrest Dr Requested By: Chris
Deputmeet: WATER Addresa: No address provided
Problem/�ssue: INSTALL AMR METER Phone Numi�er: 763-227-9759
S�hed�ed Dste: 2017-03-02 �chedaled 1lme: 09:00:00
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Cre�ed!ry: Wendy Hi�t Date Created: 201'7-02-21
ACTI03�i TAKEN:
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Status: In Pro�ess 5abmitter H��een r
Contacted
Date Compteted: Completed by:
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5�t31 iJniv�a-sitg�Avere�ae N�
Fridley, MPl 55432 ��� � � /
753-572-3566 � � � � � - � �/
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+� ��We her�by authorize the C'rty of Fridley and/or its empioyees to slo what is necessary to
replace the water�neter. 1 understand that fihe gropee�ty owner is liable for the avater line from the main to the premise and all interior
plurrtbing. (Per City code 402.06� i aiso hold the City of Fridley anclJ"rts emp{oyees harm{ess#or arry damages that may occur rrhife doing this
opee�tian. This to inciude,but not Bimited io valves,p�ping,wails,floors or the curb stop box and service lie�e. In understand I am also requir
to o�tain a permit prior to ariy worlc,�f necessary.
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FIAIAL METER READIN � � � �� � v
G(okt meter! �- 1'
Name: [ J�l�('1�j Address � � 1 1 �''ei� �
- Phone Number �������'l�� Date_��' (i'� '�
Signature ...-„--�.... Witness Signature
Oi.D METER# �� �� 1�.�� 1�
OLD READ[NG �"��� I k7�
NEW METER# �"��O �O �� �'''��
NEW READtNG_�J
ERT# � �c�'J O\.J 1 � D
FRiDLEY ClTY CODE
CHAP'TER 4�02.WATER,STORM WATER AAID SANITARY SEWER
ADMIAttSTRATION
(Ref Ord No 113,46�t,565,566,529,638,662,92Z,988,1144,1156,i191)
402.5 PERNf1T FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipat system and a�y house or building for wfiich the
appiication is made,the owner or corrtractor sha(I be requtred to obtain a permrt for such oonnection,and shall pay a permit fee as pravided in•
Chapter 11 of this Code. After sucfi connection has been rnade,the Water and Sewer Departmertt shall be not�ed. it shall lm untawfui to cove
any connecting line until an inspection has been made and such connect�oa and the work incideM there�to has been approved by the C�ty as a
proper and witable connection.
402.06 REPAlRS AND l4(AlNTENANCE Ta COidt�ECTfON
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 service iead has
been extended to fihe property Iine for connection,the appiicarrt,owner,or accupan#or user vf such premises shafl be liaMe for ali repairs
required to any water t�ne and sewer lines necessary for cunnection of the premises from the main to the prem'�ses. ff tl�e property owner
requests mairrtenance senrice or repairs be performed by the Crty,#he properi.y owner shall be charged for the�o#ihe maintenance and/or
repairs,including necessary street repairs at a rate set annuaUy by an adminis�b�ative poliry, ft shall be ifie responsbility of the applicarrt,
owner;occuparrC or user tu perform standard maimes�ance of tfie sewer service tine firom the premises to the main induding deb�dearing or
root cutting and to mairrtain the water service wrb stop box for operability and at such height as wilt ensure that it remai�abmre the finished
grade of the land or property. {Ref 638,1156,1191)