Meter Swap ` Request Number: 14379
Pubhc works Division
Service Request
Problem Addresa: 1560 Trollhagen Dr Requested By: 1liomas
DepArtment: WA'IER Addresa: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-801-7754
Sc dDate: 2017-04-OS �� Sc�edaled'ilme: 01:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Cre�ed: 201'1-03-29
ACTION TAI�N:
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Status: tnProgress Submitter Haa Been r
Contacted
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 ls 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 i�rterior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this
operation. This to ioclude,but not limked to valves,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) ��I � � �""
Name: Address �' v V '�/�1 �
Phone Number � V Y� v Y�����p�e `� "' � '� � `
Signature Witness Signature
OLD METER# � � �� � �0 �7
OLD READING CJ Z� � D `D
NEW METER#"I b�O ��V 1 '
NEW READING O
ERT# � ���Z���
FRIDLEY CITY 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 construding 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 contrector 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 Departme�rt shall be notified. ft shall be unlawful to wver
any connecting line umil an inspection has been made and such wnnection and the work incident thereto has been approved by the C�ty 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 servioe lead has
been extended to the property line for connection,the applicaM,owner,or occupant or user of such premises shall be IiaWe 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 maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. it shall be the responsibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris dearing 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 properry. (Ref 638,1156,1191)