Meter Swap Request Number: 13375
Public Works Division
Service Request
�_ ddress: 5591 Regis Tr Requested By: Jason
D!e\�m.mt: WA1ER Addresa: 5591 Regis Tr
Fridley,MN 55432
Prob m/Issue: INSTALL AMR METER Phone Nnmber: �63-202-7866
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�.,,� e�Date: 2 17-02-22 Scheduied 1ime: Q2:00:00
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�ACIION NEEDED:
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"� �r�' Creaited by: Beth Kondrick Date Created: 2017-0Z-OS
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� Status: 1n Progress �1��tr Hss Bee� �.
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Date Completed: a~a,��7 COmplBted by:
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Fridfey, MN 55432 / ��j
� 753-572-3566 ��� .�,l,� �l� ��� ,� p�,
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'/�� her�hy authorize the City�f Fridley and/or its empioyees to slo what is necessary�o
replace the water rnetes. 1 understand tt�at the property swner 3s�iabte for the water line#rom the main to the premise and all irnerior
plurrabing. {Per Crty coeie 402.06� i aiso hold the City ot�ridtey and/'rts employees harmtess#or any sJamages that may occur rrhile doing this
operation. This to include,but not lim�ted to valves,piping,walis,�loors or lthe curb stop box and service line. In�nderstand 1 am also requi�
to abtain a perm'rt priar#o any�rorBc,if necessaey.
FINAL NIETER READING(o1d meter) `�� � ✓ ��
Name:_��O'1� Address �r.
Phone�lum[ser�IX�i7 ` �r�..` 7$�Q ��_� �-- �� :
Signature Witness Signarture
o�o���R�_�.���a���
OLD READtNG_. ��"� (!,�l!
NEW METER#_ 1� 1 v�C0 5 (
NEW READIIVG �
ERT# _ t lS � 1 � V .
FR1DLfY CITY CODE
CHAPTER 402.WATER,STORM WATER A911D S.RNITARY SEWER
ADMINISTRATIC7S�i
(Ref Ord No 113,464,565,566,529,638,562,922,988,1144,i156,I191)
402.5 PERMIT FEE
Prior to tmnstructing ur repair of ar�y water of sewer fine connecting the existing muniapal system and any fiouse oc bu7ding for which the
epplicatiun is made,the owner or cor�tractor shall be required to obtain a permit for such connection,and s6alt pay a permit fee as provided in•
Chapter 11 af this Code. After such connection has been made,the Water a�d Sewer Departrnent shat4 be notified. It sha8 I�uniawfu(to cove
any connecting line untii an inspection has 6een made and such connection and the word�inciderrt thereto has been approved by the Gty as a
proper and suitable connec#ion.
' �02.06 REPAIRS Ati1tD MAINTEtYANCE TO CONNECTIOIVI
After the initiai connectioa has been made to#he water service curb stop box or the sewer lead at fihe property ii�e or a water�rvioee lead Nas
been extended#o fihe property line for connection,the app{icarrt,owner,or occupant or user af such premises sf�ali be ifabte for all repairs
required fio any water line and sewer IInes necessary#os connection of tfie premises from the main to the premises. If the property owner
reyuests mairrtenance seroice or repairs be perFormed by the City,the property owner shall be charged for#he costs of the matrrtenarrce and/or
repairs,including necessary street repain at a rate set annually by an adminis#rative po19ry. It shal!be ti�e responsibility of the applicarrt,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the main inciuding debris dearing or
root cutfiing and to maintain the water service surb stop box for o�►erability and at such height as wili ensure that it remains above the finished
grade of the land or property. {Ref 638,1156,1191)
M.