Meter Swap � ' Request Number: 14310
Public Works Division
Service Request
Problem Address: 1331 Skywaod Ln Requested By: Yohaames
Department: WA1ER Address: No address provided
ProWemiIssue: INSTALL AMR METER Phone Number:
Sc6ed�iled Date.: 2017-04-07 Sc{�edoled 11me: 02:00:00
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ACTION NEEDED:
Created by: Heth Konch�ick Date Created: 201?-03-24 °'
ACTi4N TAKEN: �
�Y � � ���
Status: In Progess Sebmitter Hss Beeu r
Coutacted
Date Complete�l: Completed by:
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` Ci of Fridle �� ��`` �
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Water Department
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
�1We hereby authorize the City of Fridley and/or its empbyees to do what is neaessary to
repface the water meter. 1 understand that the property owner is liable for the water line from tfie main to the premise and ail interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its empfoyees harmless for any damages that may oaur white doing this
operation. This to include,but not fimited to valves,piping,walls,floors or the curb stop box and senrice line. !n understand!am also required
to obtain a permit prior to any work,if necessary.
FINAI.METER READiNG(old meterj O� � 1 � �
Name• I b�V��� Address � J� � r,�U �� �
Phone Number Rate ��� ~ t�-
Signature Witness Signature
OLD METER#__� U� �� C�`'1 -I �j
OLD READING �� � � �J�
NEW METER# ����1q `� f
NEW REAOING �
ERT# 1 ����� ��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER ANU SANITARY SEWER
ADMINISTRA'i'ION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prlor to constructing or repair of any watec of sewer line connecting the existing municlpal system and any house or building for which the
appllcation is made,the owner or corrtrector shall be required to obtain a permit for such connectton,and shall pay a permit fee as provided in
Chapter 11 ofi this Code. After such connection has been made,the Water and Sewer Department shaN be notif'red. It sha{I be uniawFul to cover
any connecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has beee made to Che water service curb stop box or the sewer lead at the property line or a water service lead has
6eee extended to the proqerty line for connedion,the applica�rt,owner,or occupant or user of such premises shaU be(iable for all repairs
required to any water line and sewer lines necessary for connedion 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 sfiail be charged for ihe costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaNy by an administrative poliry. It shall be the respoosibility of the applicant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main inc{uding debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that tt remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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City of Fridley -
Water Department
Address ,���� ..S/�y�.y,,6� L.,it�
,
Name_ � ,��%� .
Date / - .i.J -�% �
Old Meter Number ���f�/��
Old Meter Reading G� �S,C�
,
Repl acement No._ �,� S"'�G� �f ��
Replacement Reading_ Q'
Replacement Make��,c�rca—
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Remarks• (J %a( ya�,��t�;x_
Signed �% .
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