Meter Swap rL
� Request Number: 14254
Public Works Division
Service Request
ProMem Address: 1460 Wi�emere Dr Requeated By: Lois
Depprtmeat: WATER Address: No ad�rress provided
Problem/Issae: IN5TALL AMR METER Phone Number: 574-1286
Sc�ed�l 2017-03-30 Scheduled'Ilme: 01:00:00
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ACTION NEEDED:
Cre�ted by: Wendy Hiatt Date Cre�ed 2017-03-22
ACTiON TAI�N:
� s� CCed _ �;� �--
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- Statas: In Progcess Su6mEtter Haa Beea �
CoM�eted
Date Com�eted: 3^�d —(,�' Compieted by: t �` �
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City of Fridley �� .� 7� ` Cl 'Z
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridiey and/or its employees to do what is necessary to
replace the water meter. 1 understand that the properly owner is liable for the water line from the main to the premise and all irnerior
plumbing. (Per City code 402.06j 1 also hold the City of Fridley and/its employees harmless for any damages that may ocwr wh�le doing this
operation. This to indude,but not limited to vaives,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.
�iNAL METER READING(old meterT �a sa��a
Name: ��'�j Address_ ��w"� '�}�YI��i��°�iO� �--
Phone Number � I � I�V� Date d ~ �~ 4 [_
Signature Witness Signature `
OLD METER# ���� ��
OLD READING �� 8� ��a
NEW METER# ` ` �� v"� ��
NEW READING �
ERT# � � � � ' � � �
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 constructing or repair of any water of sewer line connecting the existing municipal system and ariy house or bu�iirq�for whkh the
application is made,the owner or corrtredor shall be required to obtain a permit for such connection,and shall pay a permit fee as pro+nded in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer DepartmeM shall be notified. It shall be untawful to co�rer
any connecting line until an inspection has been made and such connection and the wortc incideat thereto has been approved by the City as a
proper and witable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
Afte�the initia(connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water service kad ha�s
been extend¢d to the property line for connettion,the applicant,owne�,or oaupant or user of such premises shall be liabte far alt repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If!he property owner
requests maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the maiMenance artd/or
repairs,inciuding necessary street repairs at a rate set annually by an adminisCrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perForm standard maintenance of the sewer service(i�e 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 wch heigfrt as will ensure that it remai�at�ve the ffnished
grade of the land or property. (Ref 638,1156,1191)