Meter Swap Request Number: 14288
Public works Division
Service Request
Problem Address: 1655 Mississippi St Requested By: Judith
DepartmeM: WATER Address: No address provided
Problem/Issue: INSTALL AMIt ME1ER Phone Number: 763-205-0253
Scheduled Dxte: 2017-03-31 Schednled 11me: 01:00:00
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ACIION NEEDED:
Created by: Beth Ko�drick Date Created: 2017-03-23
ACTION TAI�N:
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Statua: In Progress Snbmitter Has Been r
Contncted
Dxte Completed: 3 — '��� ��' Completed by: ���
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�,. � City of Fridley � �� �� � 1
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Frid{ey and/or its employees to do what ls necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for ar�y damages that may ouur whlle doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop bax and service line. in understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) D �� ��
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Name. ^'1,•�.�U� Address Ylll/c�� �+U��J' � rJ�J6��r�j, �.
Phone Number `�3 '�a�J " 0��J Date J'� �''� ��
Signature Witness Signature �-�
OLD METER# � ` � " � t�V
OLD READING �v �� ��-`�'
NEW METER# � 1 �� � v V✓ �
NEW READING �
ERT# r ��� � � � (
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAN{TARY SEWER
ADMIN{STRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existi�g mu�icipal system and arry house or twildi�for which the
application is made,the owner or contrador shall be required to obtain a permit for such connection,and shalt pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shatt be notified. It shall be unlawful ta c�nrer
any connecting line 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 CONNEC7'ION
After the lnitial connection has been made to the water service curb stop box or the sewer lead at the property line ar a water service lead has
been extended to the property line for wnnection,the applicant,owner,or occupant o�user of such premises shall be liabfe for aN repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property awner
requests maintenance service or repairs be performed by the City,the p�operty ow�er shall be charged for the costs of the mairrtenance andJor
repairs,including necessary street repairs at a rate set annually by an admi�istrative policy. It shall be the responsibi{ity af the applicant,
owner,occupant or user to perform standard maintenance of the sewer�rvice line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)