Meter Swap y Request Number: 14376
Public works Division
Service Request
Problem Address: 5381 Madison St Requested By: Sara
w"'` DepArtment: WA1ER Address: No address provided
ProWem/�ssue: IN5TALL AMR METER Phone Numbcr: 651-367-9774
Scheduled Date: 2017-04-04 � Schedalad'llme: 01:30:Of1
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ACIION NEEDED:
Created by: Wendy Hiatt Date Cre�ted: 201'7-03-29
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ACTIUI�;TAI�N:
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Sts�tus: In Progress Snbmitter Has Been r
Cont�ted
Date Completed: �r � �� `� Completed by: J���
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• City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridley andjor its employees to do whet is netessary to
replace the water meter. 1 understand that the property owner is fiable for the water line from the main to the premise and all i�erior
plumbing. (Per City code 402.06) 1 aiso hold the City of Fridley and/its employees harmless for any damages that may ocs�r while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. le understand 1 am also required
to abtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �� � ��
Name: �� Address ��i> l ��� ��.
Phone Number �/J�� ��� ~ 1� ! 1 Date �� '�' � /
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Signature Witness Signature
OLD METER# ��� i � �� l
OLD READING _ � � ! ��v
NEW METER# `�' � y�� � I v�
NEW READING �
E�# �l 22 � � I ��
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 to constructing or repair of any water of sewer fine connecting the existing municipal system and any house or building for which the
application is made,the owner or comractor shall be required to ot�tain a permit for such connection,and shaif pay a permlt fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer DeparCment sha{I be notified. It shaff be unlawFul to cove�
any tonnecting line until an inspection has been made and such connection and the work tncident thereto has been appraved by the�ty as a
proper and suitable wn�ection.
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 property line or a water service fead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shal!be liable for alf repairs
required to any water line and sewer Nnes necessary for wnnection of the premises from the main to the premises. tf the property a�vner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuatly by an administrative poiiry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main includi�g debrts dearing or
root cutting a�d to maintain the water service curb stop box for operability and at such heigfit as witl ensure that it remaf�s above the finished
grade of the land or property. (Ref 638,1156,1191�