Meter Swap ,
Request Number: 13502
Public Works Division
Service Request
Problem At�dress: I200 Regis Ln Requested By: Aiv�s Stumbris
„�f:�, 1200 Reg�s In
Depnrt . WATER Addres:: Fridley,MN 55432
ProMe�JIssne: INSTALZ AMR ME1ER Phone Number: 651-269-0906
' Scheduled Date: 2017-03-01 Scheieled 11me: O1:fl0:00
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ACTION NEEDED:
Created by: Beth Konc�ick Date Crea�ed: 2017-02-l S
ACTION TAKFN:
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� � Strtus: In Progcess ���er Has Been �.,
Contacted
Datc Compteteds 3 — 1 �. ' � Completed by: �� e
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5431 i9nBversit'/Aaere�ae 6Y�
�ridlsy, MN 55432
_ 363-5?2-3565 "') � (; � � � � � I � ,(, �
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` ,/'A°� hereby authorize the�'rty�f Fridley andJor its employees to do what is necessary to
replace the water meter. 1 vnderstand that the property owner as liable for the wafiee line from the main to the premise and a!1 interior
piumbing. (Per C"rry soele 402.06j 1 adso hold the Crty of Fridiey and/'rts employees harmless#or eny damages tfiat may occur while doing this
oper�tion. This to 9ncfude,bufi not limited io va4ves,piping,wafls,floors ar the curb sto�box snd senrice 1ine. tn understand�am also requir
to obtain a permit prio�r#o any�rorlc,�f aecessary. O
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FtNAL MEi'ER ftfADiNG(oPd mefier� ����� �
Name: —I J ����j �f�Ll�h,� 7 Address ���4 �i�l�� �
Phone Number �Q" �� �q `� ;, 0(� Date � — � r � [
Signature ^�'
Witness Signature
OLD METER# ��,�i � � 3��
OtD READtNG__ 6 (7' cl `��U
I�i�W METER# 1�� 1 " � � � �
N�W READIIVG �
��T#_ �l L � I � � `� I
FRIDL�Y CITY CC3DE
CHAPT�R 402.WATER,STORM WATER AND S�N{TARY SEWER
ADMlNISTRATIC7N
�Ref Ord No 113,�64,565,566,6Z9,638,662,922,988,i1�44,1156,1191)
4U2.5 FER1VlIT fEE
Prior to constructing or�-epair of arry wa#er of sewer line connecting the existing municigal system and any house or buiiding for which the
appl�cafiion is made,the oarner or contractos shall 6e required to abtain a permit for such connecCion,aad s(�a41 pay a permit fee as provided irr
Chapter 11 of this Code. After such connecCion has been�sade,the Water and Sewer Departmerrt shall be notified. tt sha{I be uniawFul to cove
any connecting line unt�l an inspection bas been made aad such connectian and the wor�c inciderrt thereto has beert aqproved by the C'rty as a
proper and witabte connection.
402.06 REPAiRS AND l41A1NTENANCE TO COAINECTiON
After tfie initial cannectiun has been made to the water service turb stop box or the sewec lead at fiE�e properey iine or a water s�rvice iead has
been extended#o fihe property)ine for connection,the appiicarn,owner,or accupant or�ser o#such pcemises shal{be iiabte for ail re�airs
required to any water tine and sewer lines necessary#or connection of the premises from the maia to the premises. ff the property owner
requests mai�rtenance serroice or repairs be serFormed by the City,the property owner shap be cFiarged for the cos#s o�f the mairrtenance and/or
repairs,inctuding necessary s�treet repairs a#a rate set anaually!ry an administrative policy. It shail be the res�onsibilitq of the applicar►t,
owner,occupant oc user tv perForm standard mairrtenance of the sewer service line from the premises to the main including ctebiris dearir�g or
root cutting and to mairrtain the water service curb stop box fo�operabi4+ty and afi such height as wlfl ensure that it remair�a6ove the finisF�ed
grade of#he land or propecty. {Ref 638,1155,1191j