Meter Swap , � Request Number: 12697
Pubhc works Division
Service Rec�uest
Problem Addresa: 7502 Sth St Requested By: Tom Shypulsld
7502 Sth St
Departme�: WATER Addreas: Fridley,MN 55432
Problem/Is:ne: INSTALL AMR METER Phone Nnmber: 763-7846637
ScLedaled Date: 2017-01�10 Schedaled Tlme: 08:30:00
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ACIION NEEDED:It�tall AMR
Crexted by: Beth Ko�ick Date Cre�ed: 2017-01-03 �
ACIION TAI�.N• �
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�S1� Snbaiittcr Haa Been
Stat�u: In Progress Coutacted �
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D�te Compieted: Completed by:
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City of Fridley �p� � �'�O $�O ._. D�
Water Department �
6431 University Avenue NE
� � Fridley,MN 55432 � � � � / � /
` 763-5723566 ✓
iJwe hereby authorize the City of Pridley and/or 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 iMerior
plumbing. (Per City code 442.06) I afso hofd the City of Fridiey andJits employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,wafis,ftoors or the curb stop boz and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
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FiNAL METER READING(old meter)
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Name:_, �'�r \ ` �l`"' Address � :Jll�.,r / CJ
Phone Number�� �� p�_ 1 � �,�""�4 1
�Si nature T Witness Signature
OLD METER# � 2� � � ��
OLD READiNG�� L�� �
NEW METER# � r� t e����
NEW READING `./
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FRIDLEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATIOAI
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buildir�g for which the
application is made,the owner or corrtrador shati be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection fias been made,the Water and Sewer Department shall be notified. It shail be unlarvful to cover
any connecting line until an inspection has been rsiade and such connection and the work lncident thereto has been approved by the City as a
proper and suitabte connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the inittal connecCion has been made to the water serwice curb stop box or the sewer lead at the property line or a wate�service lead has
been extended to the property line for connection,the applicant,owner,or accupaM or user of such premises shall be lial�e for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property o+aner
requests mairrkenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the mairttenance and/or
repairs,inc{uding oecessary street repairs at a rate set annually by an administrattve poliry. R shatl be the responsibility of the applicant,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premises to the main induding debris clearing or
root cutting and to mainta'sn the water service curb stop box for operability and at such height as will ensure that it remains above the fintshed
grade of the land or property. (Ref 638,1156,3191)