Meter Swap Request Number: 14451
Public Works Division
Service Request
Problem Address: 5173 St.Moritz Dr Requested By: Roxazme Cavaloxi
Department: WATER Address: No address provided
ProblemlIssue: INSTALL AMR METER Phone Number: 763-572-3935
Scheduled Date: 2017-04-06 Scheduled T'ime: 11:00:00
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ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-03-31
ACTION TAI�N:
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Status: In Progress Submitter Has Been �,
Contacted
Date Completed: Completed by:
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City of Fridiey �� � ��j�
Water Department V
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the C'�ty of fridiey and/or its empioyees 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 ail inte�ior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley andJits employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to vafves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � � �� ���
Name: �`^N Q,��� Address_ ��� � �� ���� ��
PhonaNumber����� v ����Date ���� ��
Signature ������ Witness Signature
OLD METER# l ��� r ' V�
OLD READING 1 �, �� ��D
NEW METER# � 4 C�t�./ �Q 1
NEW READING �
ERT# � ZZ� � �� �
FRIDLEY ClTY CODE
CHAPTER 4U2.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 connectton,and shal!pay a permit fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer Department shall be notified. ft sfiall be unlawful to cover
any connecting line until 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 MAINTENAPICE TO CONNECTfON
After the initial connection has been made to the water service curb stop box or the sewer lead at the p�operty line or a water se�vice lead has
been extended to the property line for connedion,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 property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maitrtenance andjor
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. It shal!be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main indudtng debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wilf ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)