Meter Swap .
' Request Number: 14786
Public works Division
Service Request
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Problem Address: 1300 Skyv�rood Ct Requested By: Touy Chester
Department: WA'IER Addresa: No address provided
Problem/Issne: INSTALL AMR METER Phoae Namber: 612-232-8U52
ScLeduled Date: 2017-04-27 Schednlad Time: Q2:00:00
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ACIION NEEDED:
a-<:'' Created by: Wendy Hiatt Date Created: 2017-04-19
AC1iON TAI�N:
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Status: In Progress 5nbmitter Has Been �r., .
Co�acted
Date Completed: �^-a,�--�� Completed by: ��`, �
Honrs �C�
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•. City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the C'�ty af fridiey and/or its employees to do what is necessary to
replace the water meter, t understand that the property owner is fiable for tfie water line from the main to the premise and aii iMerior
plumbing. (Per City code 402.06) i a{w hold the City of Fridiey and/its empioyees harmless for any damages that may occur while doing this
" o ration. This to inc{ude,but not limited to valves,
pe piping,walis,floors or the curb stop box and service lioe. In understand 1 am also requi�ed
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �����
Name• ��'� tJ14C�J� Acfdress 1��v � ,
Phone Number 1.1t���,�` �JoG `"�V J� Date_ VU� ` V � J
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Signature Witness Signature
OLDMETER# `� �� � ���
OLD READING ������
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NEW METER# �� v
NEW READiNG � �
ERT# � q(�,��`� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STfJRM WATER AND SANfTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,6fi2,922,988,1144,1156,1191)
402.5 PERMiT PEE
Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or building for wfiich the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and sha{I pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has bee�made,the Water and Sewer Department shall be not�ed. It shall be unlawfui 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 MAINTEPIANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property tine or a wa�r sBrvice lead fias
been extended to the property line for connection,the applicant,owner,or occupa�t or user of such presnises shaN be liable for aN repairs
required to any water line and sewer lines necessary for co�nection of the prerr�ises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,tfie property owner shalt be charged for the costs of the mairrtenance and/or
repairs,including�ecessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibilFty of the appiicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding deb�is clea�ing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the tinished
grade of the fand or property. (Ref 638,1156,1191)
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Ci�y of Fridley
Water Department
Address����� sC�� Was� Gl�-,
Name ���n�-�
Date � �1;.�/ �
'�'T
Old Meter Number� `�� ���
Old Meter Reading ���
Replacement No. �� /����--
Replacement Reading �
Replacement Make m�
Remarks: L=�.-i�!drC� ����,T_�`�rr
5igned
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