Meter Swap � Request Number: 14478
Public works Division
Service Request
Problem Address: 6125 Woody Ln Requested By: Joel H.
Department: WATER Addresa: No adda�ess provi�d
Problem/jssue� WATER ON/OFF Phone Number: 763-226-7274
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AC1�ON NEEDED:Ti�rn off w�er so val�e can be replaced Install AMR.
CreAted by: Wendy Hiatt bate Created 2017-04-03
ACIION TAi�N:
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Statua: In Progcess Submitter Has Been �..
Contacted
Date Compieted: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE .�a3 ,(��/`d�p—t�'�-
Fridley,MN 55432
763-572-3566
�/We hereby authorize the C'ity of Fridley and/or its empfoyees to do wha!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 ail interior
plumbing. �Per City code 402.06j 1 also hoid the City of fridley and/its employees harmless for arry damages that may ocaar Mrhile doing this
operation. This to include,but not limited to vaives,piping,walls,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) �� `���
Name• Address l�J��� `�JV�"1 �-�N
Phone Number Date '' � C
Signature Witness Signature
OLD METER# �� � J �'�
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OLD READING 3 �9 3�
NEW METER# r y(�,O {� t ` �
NEW READING N
ERT# � �(���� �
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FRIDIEY CITY CODE
CHAP7ER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,529,638,662,922,988,1144,1156,1191)
d02.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line conneding the existing municlpal system and any house or building for whicfi the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 af this Code. After such connection has been made.the Water and Sewer DepartmeM shaN be notifled. It shaii be unlawful to co�r
any connecting line until an inspection fias been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONPIECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water�rvke lead has
been extended to the property fine for connedion,the applicaM,owner,or oaupant or user of such premises shail be liabie for ali repairs
required to any water line and sewer{ines necessary for connection of the premises from the main to the premises. ff the properly owner
requests maintenance service or repairs be performed by the tity,the property owner shall be charged for the costs of the maiMena�ce arnl/or
repairs,including necessary street repatrs at a rate set annuaily by an administrative policy. It shalf be the responsibiiity of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maiMain the water seroice wrb 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)