Meter Swap - Request Number: 14491
Public Works Division
Service Request
Problem Address: 5194 Matterhorn Dt Requested By: Roland
Department: WA'IER Addreas: No address provided
ProMem/Tsene: INSTALL AMR METER Phone Number: 763-571-7587
Scheduled Date: 2017-04-10 Scheduled 1lme: 11:00:00
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ACTION NEEDED:
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Cre�ted by: Beth Ka�ick Date Created: 2017-04-03
ACTION TAI�N:
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Statua: In Progress Submitter Aas Beeg r
Coutacted
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D�te Completed: �� ��'1� 1� Compteted by: ` _ ��
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
I/we hereby authorize the Ctty of Fridley and/or its employees to do vrhat is necessary to
replace the water meter. 1 understand that the property owner is liable for the water li�e from the main to the premise and all irrterior
plumbing. (Per City cade 402.06) I also hold the City of Fridley andJits employees harmless for any damages that may occur while doing this
operation. This to indude,but not limited to valves,piping,walls,floors or the curb stop box and service{ine. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterJ `� ��" ��
Name: 1�-�J��`-�� Address �� 1� N�.�'� -t�11 t K..V " `� ��
Pfione Number ������ �` ��v , Date �` 1� ' � �
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Signature Witness Signature
OLD METER# `�' ��`���`��
OLD READING �� � � I �D
NEW METER# � 1�`"� � v ` `�
NEW READING �
ERT# �aal ��� i
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINIS7RATfON
(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 line connecting the existing municipal system and any house or buildtag far which the
application is made,the owner or contractor shall be required to obtain a permit for such wnnection,and sfiall 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 notified. It shall be unlawful to�r
any connecting{ine until an inspedion has been made and such connedion and the work i�cident thereto has been approved by t�e City as a
proper and suitable connection.
402.06 REPAIRS AND MAfNTENANCE TO CONNECTION
Afte�the initial connedion fias been made to the water servlce curb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property Itne for wnnedion,the applicant,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water line and sewer{ines necessary for connectlon of the premises from the main to the premises. ff the property�rner
requests maintenance service or repairs be performed by the City,the property owner sfiall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. 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 including debris clearing or
root cutting and to maintai�the water service curb stop box for operabil'�ty and at such height as will ensure that tt remains above the finished
grade of the land or property. �Ref 638,1156,1191)