Meter Swap <
' - Request Number: 14091
Public Works Division
Service Request
Problem Address: 5215 Pierce St Req�sted By: Joseph
Depxrtment: WA'IER Address: No address�ovided
Pro6iemllssue: INSTALL AMR METER Phoae Number: 763-571-4682
Selkduled Date: 2017-03-21 Schedeled Time: 11:30:00
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ACTION NEEDED:
Crented by: Beth Koadrick D�e Crerted: 2017-03-14
ACTION TAICEN:
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Statas: 1n Progess Submitter Hu Bees r
Cont�cted
Date Compieted: Compietod by:
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Cityt of Fridley
WaCer Department
�' 6431 University Avenue NE
' � Fridley,MN 55432
' 763-572-3566
�/+Ke hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. 1 understand that tfie property owner is liable for the water{ine from the main to the premise and a{{i�erior
plumbing. (Per City code 402.06j 1 also hold the�ty of Fridley and/its employees harmless for anq damages that may occur whife doing this
operatian. This to include,but not iimited to valves,piping,walis,floors or the wrb stop box and service fine. fn understand I am also required
to obtain a permit priar to any wo�tc,if necessary.
FINAL METER READtNG(oid meter) � �(� ��
Name: Address �� `� �i�^w �
Phone Number p� ��` �— �
Signature Witness Signature
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�LD METER# �J �J�-�� V �� " �
OtD READtNG � � � " �� �O
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I�jC���,,� `'�(� � �
NEW METER# V 4L.JE.) �� r' 1 �' �
NEW READ{NG Y-� O
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ERT# �� l�V (�'}V 1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ,
ADMfNISTRATION
' (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to construding or repair of any water of sewer tine connecting tF�e existing municipal sys#em and arry house or building for whkh the
app4icatio�is made,the owner ar corrtractor shall be required to obtain a permit for wch connedion,and shall pay a permit fee as provided irr
Chapter 11 ofi this Code. After such connection has been made,the Water and Sewer Departmerrt shaU be notified. it shalt be un(araf�il to cover
any connecting line until an inspection has been made and such connection and the work inciderrt thereto has been approved by the Gry as a
proper and suitable connection.
402.06 REPAiRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop bax or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicam,orvner,or accuparrt or user of wch premises shail be liable for aif repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owoes
requests maintenance senrice or repairs be performed by the City,the properiy owner shaU be charged for the costs of the mairrtenar�ce andjor
repairs.including necessary street repairs at a rate set ans�ually by a�administrative poliry. It shail be the responsibility af the applicarrt,
owner,occupant or user to per�orm standard maintenance af the sewer service line from the premises to the main inciudi�de6ris dearing vr
root cutting and to mai�tain the water service curb stop box for operability and at suth height as wifi ensure that it remair�s above the finished
grade of the land or property. (Ref 638,1156,1391)
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Date :�'!.2�� 8�
Old Meter Number � 9,3 d y'g 2g
Old Meter Reading '
Replacement No. c� ��p �g�,,;3Z,
Replacement Reading m
Replacement Make��C.-^
Remarks• ,j Yc9 /r,,,•� �,r�f��'
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S ignedr---"