Meter Swap a Request Number: 14645
Public Works Division
Service Request
Problem Address: 5333 Matterhorn Circle Requested By: Bernice Dietz
Departraent: WATER Address: No address provided
ProblemlIssue: INSTALL AMR METER Phone Number: 763-571-1478
Scheduled Date: 2017-04-18 Schednled'ITime: 01:00:00
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ACITON NEEDED:
Created by: Beth Kondrick Date Created: 2017-04-12
ACTION TAI�N: �� � �� � �'��
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5tatus: In Progress Submitter Has Been C
Contacted
Date Completed: Completed by:
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Gty of Fridley �/ �
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Water Department �
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/a►e hereby authorize the C�ty of Eridley and/or�iis emptoyces to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water tine from the main to the prem(se and all interior
piumbing. (Per City code 402.06) i aiso hold the�ty of Fridley and/its employees harmless for any damag�s that may oaur while doing this
operetion. This to include,but not limited to vah►es,piping,walls,floors or the curb stop box and service line. in understand l am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter) � � ` ` O
Name: ( Address �� d� ti���► �w� � C/��
Phone Number L�P�'�� (�"- ���� Date_ "l��+�� ��
Signature ����'�"'" Witness Signature_��,/ \ �
OLD METER# _4�0�� / ��
OlD READING �� � �. l Q
NEW METER# � 1 � ���U
NEW READING l J
ERT# ��Z� � � J�
FRfDLEY CITY CODE
CHAPTER 402.WATER,5TORM WATER AND SANITARY SEWER
ADMINISTRASION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERM{T FEE
Prior to constructing or repair of any water of sewer{ine connecting the existtng municipal system and arry house or bu4lding for which the
app{ication is made,the owner or contrador shall be required to obtain a permit for such connedion,and shail pay a permlt 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 cover
arry connecting iine until 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 MAINTENANCE TO CONNECTION
After the initiat connection has been made to the water service cu�b stop box or the sewer lead at the property line or a water service tead has
been extended to the property line for con�ection,the applicant,owner,or occupant or user of such premises shali be liabie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests mairitenance senrice or repairs be perEormed by the City,the property owner shali be charged for the costs of the mairKenance andJor
repai►s,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the rs�ain including deb�is dearing or
root cutting and to maintain the water service curb stop box for operability and at suth height as wiil ensure that it remains above the�nished
grade of the land or property. (Ref 638,1156,1191)