Meter Swap Request Number: 14366
Puinhc Works Division
Service R.equest
Problem Address: 5291 Matterhorn Dr Reqnested By: David Jolmson
Department: WATER A�ddress: No ad�fress provided
Problem/Iss►ae: INSTALL AMR METER P6ose Number: 571-2713
Sc�dufed Late: 2017-04-04 duled 11me: 04:00:00
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ACTiON NEEDED:
Cres�ted by: Wendy Hiatt Date Created: 2017-03-28 °`°'
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A(."TION TAI�N: � ,� ���'`�
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CX.�' � 1 " —
Status: In Progress Sabmitter Aas Bees �
Coututed
Ds�te Completed: � ;,, U,_ I� Completed by: � ��LyQ
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City of Fridley ��� '�j��
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 what is necessary to
replace tfie water meter. 1 understand that the property owner is liable for the water line from the main to the premise and ali i�rterior
plumbing. (Per City code 402.06) 1 also hold the�ty of Fridley and/its employees harmless for any damages that may o�ccur while doir�this
operation. This to indude,but not limited to vaives,piping,waNs,floors or the curb stop box and service liee. in understand 1 am aiso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING{old metery �� "" ���
Name• 1�/�/1r�t�� ..���,)v�l Address �� � //vtt�l,`�t'G� r�.�V v ` ��
Phone Number � V�r� G �� Date--- �� "1�j �
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Signature Witness Signature
OLD METER#_��d � � � ��
OLD READING ��� �vv
NEW METER# � 1 I�� f i�'
NEW READING �
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� 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 construding or repair of arty water of sewer{ine connecting the existing municipal system and any house or buifding for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a�rmit fee as provided in
Cfiapter il of this Code. After such con�ection has been made,the Water and 5ewer Department shail be notified. It shall be unlawfut to�ver
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Clty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water senrice curb step box or the sewer lead at the property line o�a water ssrv�e lead has
been eztended to the property li�e for con�ection,the applica�t,owner,or ouuparrt or user of such premises shall be liabie for all repairs
required to any water line and sewer lines necessary for connection ot 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 shafl be charged for the costs aF the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris tlearing or
root cutting and to maintain the water service curb stop box for operability and at such fieight as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)