Meter Swap , � Request Number: 12665
Public Works Division
Service Request
Problem Address: 7565 4th St Requested By: Ben&c Fanily Samth
Departme�: WAZER Address: No adc�esa providcd
Problemllea�: 1NSTALL AMR METER Pho�Number: 763-568-893?
Scbeduled Dat�: 2016-12-30 � Sc�edeled T1me: 11:30:00
�a c�
ACiTON NEEDED:
Created by: Wendy Hiatt Date Created: 2016-12-30
AG'TION TAI�N:
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Status: In Progress Submitter Has Been r,
Coatacted
Datc Com�eted: Com�eted by:
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City of Fridley �
Water Department �C ��-�J ��"
6431 University Avenue NE
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� ' Fridiey,MN 55432 �� � �j��IUYU 1
763-572-3566
�lwe hereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water liae from the main to the premise and aii interior
plumbing. (Per C'ity code 402.06) i atso hold the City of Fridley andJits empioyees 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 1 am also required
to obtain a permit prior to any work,if necessary.
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FINAL NlETER READING(old meter)
Name: �� ���� \`� Address � �k:i ✓ f �7--- ,.�1
Phone Number_c�rG�"— J��� ���� Date � ���!� � �
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Signature_�,_Cr'� _!�/�/�-C/Z'.o- Witness Signature
OLD METER#__ ��� ��� �
OLD READING ���� ��
NEW METER# 1 1 � � U`v��
NEW READtNG �
ERT# VJ�� V ��3�
FRIDLEY C{TY CODE
CHAPTER 4fl2.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMlT FEE
Prior to construding or repair of any water of sewer line cannecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shali be required to obtain a permit for wch connection,and shali pay a pertnit fee as provtded in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Deqartmerrt shail be n�eci. lt shall be unlawful to wver
any connecting lir►e until an inspection has been made and such connection a�d the woric incider�t thereto has been approved by the C�ty as a
proper and suitable cannectian.
402.06 REPAIRS AND MAiNTENANCE TO CONNECf10N
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water servke tead has
been extended to the praperty line for connection,tfie applicant,owner,or occupant or user of wch premises shall be liabie for all repairs
required to any water line and sewer lines necessary for connection of tfie premises from the main to the pr�emises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged fo�the costs of the mairttenan�and/oc
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shalt be the responsibifity o�F ffie appiipM,
owner,occupant or user to perform standard maintenance af the sewer service line from the premi�s to the main including debris cfearing or
root cutting and to mairrtain the water service curb stop box for operabil'rty and at such height as will ensure that tt remains above the finisfied
grede of tfie iand or property. (Ref 638,1156,1141)