Meter Swap � � Request Number: 12660
Public works Division
Service Request
Problem Address: 7526 Sth St Requested By: Laura Sukhu
7526 Sth St
Dep�rtmeat: WA'lER �r�� Fridley,MN 55432
Problem/Issue: INSTALL AMR METER Phone Nwnber: 612-462-382S
Sched�iled Date: . 201?-01-06 Sc6edaled'IIme: 02:OO:QO
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ACiTON NEEDED:Install
Created by: Beth Kondrick Date C�eded: 2016-12-29
ACIION T �
A1��E1� �l�` �
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Sta�us: 1n Pro ss Submitter Has Been r,
� Coutacted
Date Completed: Completed by:
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City of Fridley � � � � � �
Water Department
. , 6431 University Avenue NE ���.�
Fridley,MN 55432 ���_S—j;�
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. I understand that the property owner is liable for the water line from the main to the premise and a{{interior
plumbing. (Per City code 402.06) I also hold the City 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 to any work,if necessary.
FINAL METER READING{old meter) � � � �
Name• 1/�""� SR�' Address �e:.�� ��
Phone Number �r�"�r �"��� � �� D� M'� � r
'�,signature IMtness Signature
G:-----
OLD METER# � �
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OLD READING ���� � ��C,�
NEW METER# �1 Y� ����
NEW READING V
ERT# f0 � ^' � �/ 3 � � ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINlSTRATION
(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 arry ha�se oc bu�iding for which the
application is made,the owner or co�tractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Cfiapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shail be unla�aful to cover
any connecting line until an inspection has been made and"such connectioo and the work incideM tfiereto has been approved by the City as a
proper and suitable connection.
402.06 REPAlRS AND MAtNTEIYANCE TO CONNECTfON
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 servi�lead has
been extended to the property fine for connection,the applicant,owner,or occupant or user of wch premises shall be I"�abie for all repairs
required to any water li�e and sewer lines necessary for connection of the premises from the main to tbe premises. ff the property o�aner
requests maiotenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaity by an administrative poliry, it shail be the responsibility of the applicar�t,
o�uner,occupant or user to perform standacd maintenance a�f the sgwer service line from the premises to tfie main induding debris c�earing 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 ftnished
grade of the land or property. (Ref 638,1156,1191)