Meter Swap � �
Request Number: 16177
Public Works Division
Service Request
Problem Address: 1365 Hillwind Rd Requested By: Gerald Herlofsky
Department: WA1ER Address: No ac�lress�ovided
Problem/Tssue: IN5TALL AMIt METER Phone Number: 763-412-8193
Scheduled Date: 2017-07-11 5cheduled'Rme: 10:30:00
e„'"r-- `f �
ACTTON NEEDED:
Created by: ' Wendy Hiatt Date Created: 2017-06-28
ACTION TAI�N:
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Status: Tn Progress 5ubmitter Has Been r,
Co�acted
Date Completed: �` � �� � � Completed by: ��` _
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City o�Frid6ey �� � � {C,�
Water Departra�ent L�i
6431 tJniversity Avenue NE
Fridley,MN 55432
763-57Z-3566
f/we hereby authorize the�ty o#Fridley andjor its employees to do what is necessary to
replace the water meter. t understand that the property owner is{iable for the water line from the main to the premise and ali iriteerior
plumbinga (Per City code 402.06) 1 a{so hofd the City of Fridley and/its employees harmless for any damages that may occur white tJaing this
operation. This to i�clude,but not limited to valves,piping,walis,floors or the curb stop boK and service line. in understand 1 am also required
to obtain a permit prior to any work,if necessary.
FiNAL METER READIN6(otd meterj �� � � �� �
Plame:�'���1.�� � 1�-��+��t�Y Address 13 C� 5 �� �t � �
Phone Num G�� ���� V• f � pate l `" � I � 1
�Si�natur �tness Signature �^
OLD METER# �� � � �/ � ��
OlD READING _ � ►✓ / �9 O
PtfW METER# 6 �J� �lfl ��
NEW READING �
ERT# ��� l D���
�RiDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AP1D SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,529,638,662,9a2,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to s:onstructing or repair of any water of sQwer line connecting the exisCing municipal system and any house or building fo�which the
appiication ts made,the owner or coritractor shall be requtred to obtain a permit for such wnnection,and shalt pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmem shall be notified. it shall be unlawful to cover
any connecting line until an inspection has 6een made and such connection and the work incident thereto has been appro►red by the City as a
proper and suitable connection.
402.06 REPAIRS AIYD MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service wrb stop box or the sewer lead at the property line or a water seroice lead has
been exte�ded to the property line for connection,the applicarrt,owner,or occupant or user of such premises shalt be liaWe for all repairs
required to any water tine and sewer Ilnes necessary for connedion of the premises from the main ta the premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shaii be charged for the costs of the mairrtenance and/or
repairs,including necessary sts�eet repairs at a rate set annually by an administrative policy. It shall be the responsihility of the applicant,
owner,occupant or user to perform standard mainteoance of the sewer service line from the premises to the main including debris clea�ing or
roat cutting and to maintain the water service curb stop box for operabit'ity and at such height as will ensure that it remains above the finished
�rade of the land or property. (Ref 638,115fi,1191)