Meter Swap f
� Request Number: 14100
r
Public Works Division
Service Request
Problem Address: 5251 Lincoln St Requested By: Jane
Departme�: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 574-0673
Scdeduled Date: 2017-04-12 Schednlcd'IZme: 47:00:00
!1 J
AC7ION NEEDED:
Created try: Wendy Hiatt Date Cres�ted: 2017-03-1 S
ACTION T
`V� � �
Status: In Progress Snbmitter Has Beea �..
Contacted
Date Completed: Completed by:
Honrs
T� lor'
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► r City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City af Fridley andior its empioyees to do what is necessary to
replace the water meter. i understand that the property owner is liabie for the water line from the main to the premise and all iMerior
p{umbing. (Per C'�ty code 402.06j 1 also hold the City of Fridley andJ'rts employees harmless for any damages that may occur while doi�this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In understand 1 am alsc required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �� � �`� ��
Name: ��-�� Address "��—� 1 ���I� � �
Pho�e Number ���� ��� � Date �+ `�_ `�
Signature Witness Signature
OLDMETER# ���� J�� �I
OLD READING � 1S �J F,.�� O
NEW METER# ``�- F�� "�� �
NEW READlNG �
ERT# ������� t
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior ta constructing or repair of any water of sewer line connecting the existing municipal system and arry haise or buiiding for which the
application is made,the owner or contractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. k shali be unlawful to cover
any connecting line until an inspection has been made and wch connection and the work incident tfiereto has been approved by the C'ity as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the properly line or a water service lead has
been extended to the property line for connection,the appiicaM,owner,or ocxupant or user of such premises shall be{iabfe for af{repairs
required to any water line and sewer lines necessary for wnnection 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 shall be charged for the costs of the maiaCenance and/or
repairs,including necessary street repairs at a rate set a�nually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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A�d�ess: �251 Elt��iC]OLt�I ST NE C�ac�c Phcxae: 763-�9-4963
Sd�dul�d Date: f�gr{)wne�:
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