Meter Swap �
• Request Number: 15300
Public works Division
Service Request
ProWem Address: 1490 Rice CreekRd Requested By: Joyce Marsh
Department: WA1ER Addresa: No address provided
Pre�lem/Issue: iN�V'#'ALL AMR 1NETER Phone Numbcr: 763-607-7256
Sc6eduled Date: 2017-OS-15 Schednled 1lme: 01:3U:00
5�` ;
ACIZON NEEDED:
Creafed�y: Beth Kondrick Dxte Created: 2017-OS-I 1
ACIiON TAKEN:
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Stataa: In Pro�ess Sabmitter Hns Been r
Co�acted
., Date Completed: Completed by:
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, y City of Fridley /�� � / b �
Water Departrnent , 1 Q a, l
fi431 Universi t y Avenue NE � t� � ��� O
Fridley,MN 55432 A � ,`���
763-572-3566 S� �'�
Ijwe hereby authorize the City of Fridiey and/or its employees to do what is necessary to
replace the water meter. i understand that the property ow�er is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for ar�y damages that may ocar while doir�this
operation. This to include,but not limited to vabes,piping,walls,floors or the curb stop box and senrice line. in understand 1 am also required
to obtain a permit prio�to any work,if necessary.
FINAL METER READING(old meter) � r ��J C�
Name: � � `'�"" v Address � �i ���
Pho�e Number������ p� �— t� �,�
Signature___\� Witness Signature
OLD METER#_ � i.) �-/ �`��2 F
OLD READING L '�1 � U `V
NEW METER#_`�G U l�() �v ��
NEW READING O '
ERT# r I �UZ ��O �
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 PERMlT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipal system and any ha,�se or buiiding for which the
application is made,the owner or contractor shali be required to obtain a permit for such connection,and shait pay a permit fee as provided in
Chapter 11 of this Code. After such connectia�has been made,the Wates and Sewer Departmerrt shaiS be notified. It shaff be uniavriui to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the C�ty as a
proper and suitable connection.
402.06 REPAIRS AMD MAINTENANCE TO COPINECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service tead has
been extended to the property line for connediort,the applicant,owner,or occupant or user of wch premises shaH be tiable for all repairs
required to any water line and sewer lines necessary for conneckion of the premises from the main to the premises. If the properly owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative potiry. lt shall be the responsibi(ity af the appficaM,
�� owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
�`; root cutting and to maintain the water service curb stop box for operabii'rty and at such height as will ensure that it remains above the�nished
�` grade of the land or property. (Ref 638,1156,1191)