Meter Swap Request Number: 14624
Public Works Division
Service Request
Problem Address: 5246 Matterhom Dr Requested By: Luis Aleman
Department: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-670-3779
Scheduled Date: 2017-04-17 Schednled 11me: 08:00:00
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ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-11
ACTION TAI�N:
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5tatus: 1n Progress Submitter Has Been �
Contacted
DaEe Completed: Completed by:
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City of Fridley J� � ����
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise ar�all irnerior
plumbing. (Per City wde 402.06) I also hold the City of Fridley and/'rts employees harmless for any damages that may occur while doing Lhis
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READtNG(old meter) lJ � �� { � �
Name• l�}�L�, Address__', L�� ��/�L�Y � t,��
Phone Number_/1v() ��O^ ���'"1 Date ��' I� " l�
Signature �v Witness Signature
OLD METER# 4- 1 �Z �� ( O
OLD READING ! ) �� \ � ` O
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NEW METER# �i�� � t� �
NEW READING �
ERT# I� �j���
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,2191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry ha,�se or building for which the
application is made,the owner or contrector shall be required to obtain a permit for wch connedion,and shall pay a permR fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notif'ied. It shall be unlawFul to��rer
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the C'rty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial con�ection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the properry line for connection,the applicant,owne�,or ocwpa�rt or user of such premises shall be Uable for all repairs
required to any water tine and sewer lines necessary for connection of the premises from the main to the premises. If the property o�rner
requests maintenance service or repairs be pe�formed by the City,the property owner shall be charged for the com of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. 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 including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at wch height as will ensure that it remains above the fPnished
grade of the land or property. (Ref 638,1156,1191)