Meter Swap �- r Request Number: 14248
P'ublic Works Division
SeYvice Request
Problem Address: 5228 Pierce St Requested By: Michelle
Depxrtment: WA1ER Addreas: No addr�ss providcd
ProMem/Iss�: INSTAL,L ANIIL METF.R �hanc Number: 612-388-3884
Scheduled 2017-03-29 Scted�ed 11me: 08:30:00
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ACIION NEEDED:
Created by: Wendy HiAtt Dste Created: 2017-03-22
ACTION TAI�N:
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��: ��o � Submitter Ha�Bccn r
� Coetacted
Date Completed: 3—a,��--� `� Campleted by: 1��Z�o ,
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' City of Fridley --- `� /,-,
Water Department �� � \,� t(/��
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
��We hereby authorize tfie City of Fridley andJor i�employees to do whxt is necessary M
repiace the water meter. I understand that tfie property owner is liable for the water line from the mai�W the premise and ali imerior
plumbir�g. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for arry damages that may oa�r while doing this
operation. This to include,but not limited to vaives,piping,walis,floors or the curb stop box and senrice line. In understand 1 am also required
to obtain a permit prior to arry work,if necessary.
FINAL METER READING(old meter) �4�lY��
Name: 1"t_�V� �(. �1 G Address �!�"'� �1�-°�GL' �7�•
PhoneNumber �.C��L � ���'��$ / Date _ _ ���� ~ f�
Signature Witness Signature ��
OLD METER,# _ L V V ls�/ I � L/vJ
OLD READING ��J lQ�(,.GO
NEW METER# t ��� � S ��
NEW READING �
ERT# f � �� � ` - 6 �
FRIDLEY CITY CODE
CHAPTER 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 consiruding or repair of any water of sewer line�nnecting the existing municipal system and any house or building for whkh the
application is made,the owner or contractor shall be required to obtain a permit for such con�ection.and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connectton has been made,the Water and Sewer Department shall be notified. It shall be unlawfvl to wver
any connecttng 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 wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial co�nection has been made to the water service wrb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property line for connection,the applicant,owner,or ocwpant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance andJor
repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibility aF tfie applipr�t,
owner,occupant or user to perForm standard maintenance of the sewer service li�e from the premises to the main including debris tlearing or
root cutttng and to mai�tain the water service curb stop box for operabllity and at such height as will ensure that it remalr►s above the finished
grade of the land or property. (Ref 638,1156,1191)