Meter Swap � Request Number: 15147
Public Works Division
Service Request
Problem Address: 5234 Taylor St Requested By: Mazisa
Department: WA1ER Address: No address pcovided
Problem/Issue: INSTALL AMR ME'IER Phone Number: 612-5?8-3769
Schednled e• 2017-OS-15 Sc6ed ed T'tme: 01:00:00
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ACIIUN NEEDED:
Created by: Wendy Hiatt Dsite Created: 2017-OS-04
ACTION TAKEN:
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Statns: In Progress Sabmitter Has Been �,
Coutacted
Date Completed: Completed by:
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City of Fridley �� � � � �
Water Department � �� � �
6431 University Avenue NE � � ���
Fridley,MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City af Fridfey andJits employees harmless for any damages that may ocar while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FiNAI METER READING(old meter) _�_ 1 ���� �
Name: �f,f�C�, Address ��� � �
Phone Number �' V�� t/����J' � Date_�^ �� � ��
Signature Witness Signature
OLD METER# �� � ` � O��
OLD READlNG ��� (i ���
NEW METER# r O� �fJ
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NEW READING V
ERT# � � � L� L/ � ��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMIN{STRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existi�g municipal system and any house or building for whkh the
appiication is made,the owner or rnrrtractor 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 connedion has been made,the Water and Sewer Department shall be notified. It shall 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 suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO COPtNECTION
After the initiaf connection has been made to the water senrice curb stop box or the sewer tead at the property line or a water service lead has
been extended to the property line for co�nectton,the applicant,owner,or occupaM or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for conneetion of the premises from the main to the premises. If the property owner
requests maintenance service or repairs he 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 policy. It shali be the responsibility of the applicant,
owner,occupant or user to perform standard mainte�ance of the sewer service fine from the premises to the main including debris clearing 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 finished
grade of the land or property. (Ref 638,1156,1191)