Meter Swap - ' Request Number: 13370
rublic works nivision
Service Request
Problem Address: 5'�16�Iatterhorn Dr Requested By: Bruce Wilda
Department: WA1ER Addreg$. 5640 Matterhom Dr
Fridley,MN 55432
ProMem/Issue: INSTALLAMRME'IER PhoneNnmber: , 763-572-1772
Sc6ednled Date: 2017-02-16 Scheduled Tlme: 10:00:00
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ACl'ION NEEDED:
Created by: Beth Kondrick Date Crexted: 2017-02-08
ACTION TAI�N:
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Statas: In Progress Submitter H�s Been r
Contacted
Date Completed: Completed by:
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Fradley, MN 55432
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., �/'A°� hereby authorize the Ciiy of Fridley and/or its empioyees to slo what ds necessary 40
replace#he water rneter. 1 understand that khe gropea�l.y owner is liabte for the+erater line from the main to the premise and alt errterior
pluenbing. {Per Crty code 4Q2.06) i also dtold the C'rty erf Fridley and/'rts emptoyees harmtess#or arry damages that may occur while doing this
operation. This to�nclude,but not lim�#ed to valves,piping,walls,floors or the curb stop box and senrice iine. In understand i am also requir
to obtain a permit prior to arry wor4c,if aecessary.
FIAIAL MEiER READING(old meter) � � ���
Name: ����� �V ►� Address� ��J �� r('�
Phone Alumber��� ,7���^ ����.Date !/� 1 `�
Signature Witness Signature
OLD METER#_��� ��Zu
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OLD READl1YG S y�
NEWMETER#_��? � S
NEW READt6VG O
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FRIDLEY CI�(CODE
CHAPTER 402.iA/ATER,STORM WATER AND SANITARY SEWER
ADMI1111STRATION
�Ref Ord No I13,464,565,566,529,638,662,922,988,1144,1I56,i191)
402.5 AERMiT FEE
Prior to constructing or repair of any water af sewer line connecting the existing muniapal system and ar�y house or twilding for whid�the
application is made,the owner or corrtractor sha((be required to obtain a permifi for such connedion,and shall pay a permit fee as provided in•
Chapter 11 of this Code, After such connection has been made,the Water and Sewer Departme�rt shall be notified. Ft shall be untawfid to cove
any connecting(ine urrtil an inspection has been made and such connection and the worBc inciderrt thereto has been epproved by the City as a
proper and suitable connection.
402.06 REPAIRS AWD 911tAtNTEfYA1dCE TO COMMECTION
After the initial connection has been made to the water service arb stop}wx or the sewer lead at the property iine or a water service lead has
been extended to the property line for wnnection,the appiicarrt,owner,or occupar�t or user of wch premises shaH be IiaMe for all repairs
required to any water line and sewer IFnes necessary#or connection of the premises from the mai�to tfie premises. tf the property owner
requests mairrtenance service or repairs be performed by the City,the property owner shatl be charged for the costs of the maintenance and/or
repairs,inciud�ng�ecessary street repairs at a rate set annuaily by an administrative policy. It shatl be the responsbility of the applicarit,
owner,occupant or user to perform standard mairrtenance of the sewer senrice li�e from the premises to the main including debris dearing or
root cufiting and to mairrtain the water service curb stop box for operabiiity and at such height as wifl ertsure that it remains above tf+e firtished
grade of#he land or property. (Ref 638,1156,1191J