Meter Swap Request Number: 15423
Public Works Division
Service Request
Problem Address: 5272 Matterhorn Dr Requested By: Carmen
Department: WATER Address: No address provided
Problemllssuc: INSTALL AMR METER Pho�Nuenber: 1-863-307-8886
Scheduled Dite: 2017-05-22 Schedaled 1lme: 10:30:00
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AC"ITON NEEDED:
Created by: Wendy Hiatt Date Crexted: 2017-OS-18
A ON TAi�N•
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Status: In Pro�ess �ixiultter H,�e Been r
Contuted
Date Completed: Compteted by:
�-22- � � ��
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City of Fridley � � '�j � ��3�`�/ ���
Water Department
6431 University Avenue NE C � � ����
Fridiey,MN 55432 J
763-572-3566
Ijwe hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace the water meter. i understand that the property owner is liable for the water line from the main to the premtse and ali interio�
plumbing. {Per City code 4b2.06) i also hold the City of Fridiey and/its empioyees harmfess for any damages that may occur while doing this
operation. This to include,but not limited to vafves,piping,wal{s,floors or the curb stop box and senrice line. in understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING{old meterJ � � � ! �
Neme• \��� Address �
Phone Number t' p�_ �` ���� �
Signature Witneu Signature
OLD METER# �'`'! +Dl_) ����
OLD READING ��� 4
Q
NEW METER# "'� 1 ����
NEW READING �
E�# �2��"� l �1`�
FRtDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAN{TARY SEWER
ADMINIST{tATfON
(Ref Ord No 113,$64�,565,566,629,638,662,9Z2,9$8,1144,1156,1191}
402.5 PERMlT FEE
Priar to constructing or repair of ar�y water of sewer{ine conaecting the existing municipal system and arry house or buitding for which the
appiication is made,the owner or contractor shafi be required to obtain a permit for such tonnection,and shall pay a permit fee as prov+ded in
Cfiapter il of this Code. After such wnnection has been made,the Water and Sewer Departmem shaii lse natified. It shaii be uniawfu!to cover
arry connecting line urrCii an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENAfVCE TO CONNEC7'{ON
After the initiai connectian has bee�made to the water service curb stop box or the sewer lead at the property line or a water serwce lead fias
been extended to the property line for connection.the applicant,owner,or occuparrt or user af such premises shall be liable for aii repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs af the mai�tenance and/or
repairs,inciuding necessary street repairs at a rate set annual(y by an administrative poficy. it shail be the responsibitity af the applicar�t,
owner,occupant or user to perForm standard mairrtenance of the sewer senrice fine from the premises to the main induding debris dea�irtg or
root cutting and to maintain the water servic,e curb stop box for operability and at such height as wifl ensure that it remains above#he finished
grade of the land or property. (Ref 638,115fi,11911