Meter Swap Request Number: 14659
Public Works Division
Service Request
Problem Address: 5232 Matterhom Dr Requested By: Mike Ramm
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-770-7676
ScheduledDate: 2017-04-20 Scheduled'IYme: ':�6
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ACTTON NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-13
ACTION TAI�111:
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Status: In Progress Submitter Has Been �.,
Contacted
Date Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
IJwe 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 far the water line from the main to the premise and al{interior
piumbing. (Per City cade 402.06) 1 also hold tfie C'rty af Fridley and/its employees harmless for any damages that ma�t ocar while doing this
operation. This to intlude,but not fimited to vatves,piping,walis,flnors or the wrb stop brnc and senrice line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter} � �� � �� `�'
Name: �;�' . ���� W1 Address ���� ! �-�%�-'R`"'41r'�b1"Y�
Phone Number b ���O"��� PiD pate �^ l�� �r�
Signature Witness Signature
OLD METER# C7� ` 1 �� / E..?
OLD READING �" ��� �� �
NEW METER# `'� Z lJ �J� `�'�
NEW READING �
Er�-r# i7 �2'�L�� � � °y
ERIDLEY CITY CODE
CHAP'TER 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 any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,the owner or contrador shatl be required to obtain a pe�mit for such connection,and shaii pay a permit fee as pravided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to cover
any connecting line untif an inspectton has been made and such cortnection and the work incident ihereto has been approv�d by the C'ily as a
proper and suitable connection.
402.06 REPAIRS AWD 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 rn a water service lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owrner
requests mai�rtenance service or�epaIrs be performed by the City,the property owner shali be cha►ged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate sst annually by an administrative poliry. It shafl be the�espa�sibit'rty of the applicarit,
owner,occuparit or user to perforrn standard mairrtenance of the sewer service line from the premises to the main inctuding debris clearing or
root wtting and to mairrtain the water servite curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the la�d or property. (Ref 638,1156,1191)