Meter Swap � Request Number: 14472
Public works Division
Service Request
Problem Addreas: 5178 St lmier Dr Requested By: Don Maurer
Department: WATER Address: No address provided
Problem/Issue: IN5TALL ANIIZ METER Phone Number: 612-419-4669
Sche�nled Dat 2017-04-07 Schednled Time: 11:30:0(1
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ACTION NEEDED:
Crested by: We�y Hi�t Drte Created: 2017-04-03
ACTION TAKEN:
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Statns: In Progress Snbmitter H�Been �.
Contacted
Date Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/w� hereby authorize the City of Pridtey and/or its ernplayees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06j I also hold the City of Fridley and/its employees harmiess for any damages that may occur while doing this
operation. This to indude,but not limited to valves,piping,wails,floors or tbe curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �.d� � � � � v
Name:�� \,1 �k�JU�` Address � �� V �� , �Y� � ��
PhoneNum6er �PL��;����`� - t +""' 1Date �`�� � `�°'
Signature Witness Sig�ature
OLD METER# l� U��lJ� ��
OLD READING �/� � � � �v
NEW METER# '�l t L�J I I � �
NEW READING �
ERT# � Z���� � �
FRfDLEY C1TY 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 constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shall be unlawfui to co�r
any wnnecting line urrtil an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
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 lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection 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 maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It sha{I be the responsibil'�ty af the appiicarn,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris ciearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or properly. (Ref 638,1156,1191)