Meter Swap Request Number: 14785
Public Works Division
Service Request
Probiem Address: 5241 Pierce 5t Requested By: David Holmstrom
Department: WA1ER Addresa: No address provided
Problem/�ssue: INSTALL AMR METER Phone Number: 612-750-8200
Sche e: 2017-04- 1 5cheduled 11me: 07:30:00
sT ►
r�, , � � .
ACTION NEEDED:
Created by: Wendy Niatt Dnte Creited: 201?-0419
ACIION TAI�N:
.._._�v �' _..........�._._.���_
Status: In Progress ��rter Haa Been �...,
Contncted
Dxte Completed: Completed by:
��� '� �� �� ��-
�
���:
� ��'� ��� �� �� �
� City of Fridiey S� � "%��'�'�
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liable fo�the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold the City aF Fridley and/its employees harmless for any damages that may oaur whiie doing this
operation. This to inciude,but not limited to valves,piping,walls,ffoors or the curb stop box and servtce tine. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � w � ��
Name:��A��, � � Address ��-- 11 't' 1`���e ��
Phone Number V4 ` ` +' (�l.V p�e �,� ��'� ` L
Signature Witnexs Signature
OLD METER# ���� J� � {
OLD READING '�1 �� y �lJ
NEW METER# � 1 L� �Z��
NEW READING D
E�# �� Z�Z-Zg q 1
FRIDLEY CITY CODE
CNAPTER 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 PERMfT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipal system and arry house or building for which the
application is made,the owner or co�rtractor shall be required to obtain a permit for such connection,and shali pay a permR fee as provided ie
Chapter 11 of this Code. Afte�such connection fias been made,the Water and Sewer Department shall be notified. it shall be unlawful to�ver
any wnnecting line until an inspedion has been made and such wnnection and the work incident thereto has been approved by the Gty as a
proper and suitable aonnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
ARer the initial connection has beee made to tfie water service curb stop box or the sewer lead at the property line or a water seroice lead has
been extended to the property line for connection,the appficaM,owner,or occupant or user of such premises shall be lisble for all repairs
required to any water 11ne and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance servite or repairs be performed by the City,the property owner sfiali be charged for the costs of the maintenan�and/or
repairs,including necessary street repairs at a rate set annually by an administrative poticy. It sfiall be the responsibifity of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main intluding debrls clearing or
root cutting and to maintain the water service curb stop box for operabllity and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)