Meter Swap �
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REQUEST FOR SERVICE REPORT
CITY OF FRIDLEY
Reference No. `���� Date: �_,a�'1
Request Type: �-}�YU�, Entered By: ��,
Department: ���'� Citizen Name: ��� � `�-L-
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Address: � '�J� ��ti�-�=��N� Phone Number:
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Scheduled Date: Property Owner:
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Location Details: Request Details: .
Action Taken:
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Responsible Person:
APprover:
Completion Date: �_ l�_�� Citizen Notified:
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City of Fridley ��� � l�
Water Department
6431 University Avenue NE
Fridtey,MN 55432
763-572-3566
Ijwe hereby authorize the City of Fridiey and/or its employees to do what is necessary to
replace the water meter. t understand that the property owner is liable for the water line from the main to the premise and all intedor
piumbing. (Per City code 402.06) 1 also hold the City of Fridley andJits empioyees harmless for any damages that may oca�r while doirq�d�is
operation. This to include,but not limited to valves,piping,wails,floors or the cu�b stop box and�rvice line. fn understand 1 am also required
to obtain a permit prior to any Mrork,if necessarX.
EINAL METER READIN ����
6(�I�meterj
Name• ��{ '�- ��'1� Address ,��� , �L L1,,�1 i�
Phone Num r ate �"1 — `
Signature �� ��� Witness Signature
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OLD METER# � 1 U 1 I�tJ�� � �'
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OLD READING �`1 . �
NEW METER# � t�� �� t (7 y
NEW READING � �
ERT# ��� C7� " jQ ��
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FRIDI�EIf CfTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMiNiSTRATION
(Ref Ord No 113,464,565,566,629,538,662,922,988,1144,1156,1191)
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 which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee aa�ded in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incider�t thereto has been approved by the Cty as a
proper and suitable connection.
402.06 REPAIRS AMD MAINTENANCE TO COMNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property line for connectio�,the applicant,owner,or occupant or user of such premises shali be liabie for atl repairs
required to any water line and sewer{ines 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 tor the costs of the maintenance andJor
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the appficaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing 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 flnished
grade of the land or property. �Ref 638,1156,1191)