Meter Swap , Request Number: 13064
Public Works Division
Service Request
Problem Address: 5575 W Da�xube Rd Requested By: Chris Olson
Department: , WA'IER Address: No address provided
Problem/Isaue: INSTALL AMR ME'lER Phone Number: 763-458-0179
Scheduled Date: 2017-Oi-26 Schednled'lime: 02:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Cresited: 2017-01-25
AG7ION TAI�N:
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Statas: In Progress �bmitter Has Been �
Co�acted
Date Compteted: Completed by:
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1Nater��aarta�nent
6431 lOniversity Avenue PlE
Fridley,MN 55432 ��-�(�j 7� '��
� 763-572-3566 � � � � ��� /�
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1/we her�by authorize the City of Fridley and/or its empioyees to do what is necessary to
re�lace the water meter. 1 understand that the property owner as tiable for the water line from the main to the premise and ail iMerior
plumbing. (Per Crry sode 402.06) 1 also hold the City of Fridley and/its empioyees harmless#or any damages that may occur while doing this
operation. This to include,but not limi#ed to valves,piping,waiis,floors or the curb stop box and service line. In understand i am also require�
to obtain a permit pr�or to arry wor6c,if necessary.
FINAL METER READING{old er � � � � �`-��
Name• � qddreu GJ"�,•
Phone Number�J�� -i ✓�L,! ��� p� 1"r —
Signature �,... Wltness Signature r��„��
OLD METER# I ��S { l �+ 1
OLD READlNG__ � 1 � � � ��
NEW METER# �� � 1����
NEW READIRIG
ERT# �"/�_ V� {
FRIDLEY C1TY CODE
CHAPTER 402.WATER,51'ORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,562,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house oc twtidir�for which the
appfication is made,the owner or coritractor shail be required to obtain a permit for such connection,and shall pay a permit fee as provided irr
Chapter 11 of#his Code. After such connection has been rnade,the Water and Sewer DepartmerrC shaii be notified. it shatl be uniawfiii to cover
any connecting line untii an inspection has been made and such connection and the work inaderrt thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AR1D MAINTEfYANCE TO COMNECTION
After the initial connectiort has been made to the water service cur1�stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for wnnedion,the appiicarrt,owner,or occuparrt or user of such premises shatl be liabie for all repairs
required to any wa#er li�e and sewer lines necessary for wnnectian of the premises from the main to the premises. ff the property owner
requests mairrtenance service or repairs 6e perFormed by the City,the property owner shall be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administra#ive policy. It shal!be the responsbility of the applicant,
owne�,occupant or user to perform standard mairrtenance of#he sewer senrice line from the premises to the main induding debris dearing or
root cutting and to mair�tain the water service curb stop box for operabil'rty and at such height as will ensure that it remairis above the finished
grade of the land or property. (Ref 638,1156,1191)