Meter Swap , ` Request Num6er: 13209
Public Works Division
Service Req�st
Problem Addresa: 5605 W Danube Rd Requested By: Barbara Darby
Depnrtme�: WATIIL Addresa: 5605 W I�be Rd
Fridtcy,MN 55432
Problem/Issue: INSTALL AMR ME1ER Phone Nnmber: 763-571-3015�
. Schednled Ihtte: 2017-02-14 Sc�edeled Ttme: 02:00:00
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AC'IION NEEDED:
Created by: Beth Kondrick Date Created: 2017-02-01
ACIION TAI�N:
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scat�: 1n rrogcess sgr�ia�r Ha.Beee �
Cont�tcted �
Date Completed: Completed by:
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6431 l9nev�a-si�tyfl�vena�e N� � ^ j��
Fridfey,M1N 55432 tf � � �� "'
�63-572-3566
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' �/�� hereby authorize the City of fridley and/or its empioyees to do whafi ts necessary ta
replace the water meter. I understand that the Qrope�ly oarner as tiable fo:tlte wafier line from the main to the premise and ali interior
plumbing. (Per Crty sode 902.06j i alsa hold the Crty of Fridiey and�ts emptoyees harmless#or eny damages that may occur yrhile doing this
o�eration. 7'his to indude,bufi not limi#ed to valves,piping,walls,floors or the s:urb stop box ar�d service line. In understand 1 am also requi�
to abtain a perm'rt prior to any avorlc,if necessaey.
FINAL METER READNYG(old meter) v 'i�� � ���
Name: �� `�� ��N\ T Addre� J �Ot.J� W �.
Phoae Number�����1�L l J�� Date �"� � � '�
Signature v � Witness S'�gnature
OLD METER# 1���� �(�`�
OLD READtNG � �j�� �Zv
NEWMETER# ��� � ��
N£W READ{R1G�
ERT# � �� Ir �CJ � "v .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,i156,i191 j
402.5 PERMIT FEE
Pr?or fio construding or repair of any water of sewer line connecCing the euisting municipal system and arry P�ouse or I�tildir�for Which the
applicafiifln is made,the owner or cvrrtractor shal!be required to obtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 of this Code. After such coanection has been made,the Water and Sewer Department shali be nofified. it shall be unlawful to cov�
any connecting tine untit an inspeefiion has 6een made and such connection and the wor[c inadert thereto has been approved by the C"rty as a
proper and suitabte connection.
402.06 REPAlRS AND MAINTEf11ANCE TO CONNECTIQM
After the initial connection has been made to the water service curb stop 6ox or the sewer lead at the property i�ne or a water�mke lead fias
been extended tv the property fine for connection,tbe applicarrt,owner,or accupant or user of such premises shall be Iiable for ai1 r+epairs
required fio any water line and sewer lines necessary for connection of the premises from the main to the prem�ses. ff the properl,y owner
reyuests mairrtenance service or repairs be perFormed by the C'rty,the property owner shall be charged for the costs af the ma(nteria�ce arK{(o�
repairs,induding necessary street repairs at a rate set annuaily!ay an admintstrative pol'icy. Ft shall be the responsibility of the applicarrt,
owner,ocEuparrt or user tv perform standard mairrtenance of the sewer service line from the premises to fihe main indudir�g debris dearing or
root tutting and to mairrtain the water service curb stop box for operability and at such height as will ensure tfiat it remains above the fYnished
grade of the land or property. {Ref 638,1156,1191)
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