Meter Swap : � Request Number: 12658
Public works n;v;sion
Service Request
Problem Addreas: 7558 Sth St Reque:ted By: Michael B�
Departme�: WA'IER Addresa: No address provided
Problem/Isaue: INSTALL AMR METER Phone Number: 763-780-940'1
ScLednled Dn : 2017-01-OS Sc6edaled 1ime: 11:30:00
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ACIION NEEDED:
C�e�ete�by: Wen�y Hiatt Date Crerted: 2016-12-29
ACTION TAI�N:
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Stmas: In Progress Sabmitter Nas Be�en �..,
Co�tacted
Date Completed: Completed by: � — ...__
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City of Fridley �
Water Department � � �, g �
6431 University Avenue NE
Fridley,MN 55432 ��� -��Uc�� ��
' � 763-572-3566
I/we hereby authorize the City of Fridley and/or its employees to do what 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 all interior
plumbing. (Per City code 402.06� I also hold the City of Fridley and/its emp4oyees harmless for any damages that may otcur while doing this
operation. This to include,but not limited to valves,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.
FINAL METER READING(oid meter) � " � � � ��
Name:�Y�� �N'� `� "J ��� �J �,,I`r 1 ��
Address
Phone Number ��� �� f 1� Date L � �: l `
Si n re s -
Witness Signature
OLD METER# � " V��lJ�� �
OLD READtNG ���V"4 ��CJ
NEW METER# �� �\�� � �
NEW READING �
ERT# � �✓ �/ � `/ �/� l, ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,b62,922,988,1144,1156,1191)
402.5 PERMIT FEf
Prior to constructing or repair of any water of sewer fine connecting the existing municipat system and any house or buildir�g for whid�the
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided irr
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shall be notif'ied. it shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the inittal connection has been made to the water service curb stop box or the sewer lead at the property lioe or a water senrice Iead has
been extended to the property line for connection,the applicarrt,owner,or occuparrt or user af wch premises shafl be liabfe for afi repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests mairitenance service or repairs be performed by the City,the property owner shall6e chacged for the costs of the maiotenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. ft shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maiirtenance of the sewer senrice line from the premises to the main Including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade af the land or property. (Ref 638,1156,1191)