Meter Swap 1
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. Request Number:`�
Publ�c Works Division
Sen+ice Request
Problem Addrea:: 7550 4th St Reqnested Bys David
Department: WATER Addreas: No address provided
ProblemRssne: INSTALL AMR ME�ER Pho�Numberc 6S 1-353-02�9
s��aa�ean�: Zoi7-oi-i � �a�ea��.
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AGIION NEEDED:
cr�c�a by: w�ay x��r n�cr�rea: 2o i�-oi-i 2
AG"IION TAKEN• ,
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St�ua• In Progress : Submi#ter HAs Beee �
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D�s Coa�pleteds Comgteted�y:
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City af Fridley /
Water Department � � � � � � �
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6431 University Avenue NE
Fridley, MIV 55432 a,�n��}j�
763-572-3566 ��j� �
I/we hereby authorize the City of Fridley andJor its employees to do what is 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 interior
plumbing. (Per City code 402.06) 1 also hold the�ty of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior ta any work,if necessary.
FINAL METER READING(old meter�
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Name• vt � Address_�� �� (1�
Phone Number � v �V ������� \ Date �"��✓ � `
� Slgaature Witness Signatur\
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OLD METER# l � � D� � S
OLD READING � � �� �� �
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 wnnecting the existing municipal system and any house or building for which the
application is made�the owner or wntractor shaN be required to obtain a permit for such connection,and shall pay a permtt fee as provided in
Cfiapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shall be unla�afui to cover
any connecting line until an inspection has been made and sach connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAtNTENANCE TO COINNECTtON
After the initial connectton has been made to the water service curb stop box or the sewer iead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shal!be liable for ali repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the properky owner
requests maintenance service or repairs be performed by the C'ity,the property owner shall be charged for the costs of the maintenance and/ar
repairs,inciuding necessary street r¢pairs at a rate set annualiy by an administrative poliry. 1t shalf be the responsibility of the applicarrt,
owner,occupa�t or user to perfo�m standard mairrte�ance of the sewer service line from the premises to the mai�including debris ciearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiit ensure that it remains above the finished
grade of the land or property. {Ref 638,1156,1191)