Meter Swap I � t
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Fridley
R�quest Number. 17335
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ProW em A�ddte�s: 1647 68th Ave Requested$y: Ter�sa or 3�
Departmeei: WA1ER Address: No addr�as providsd .,�.
Problem/Is�ns: INSTALL AMR ME1ER Phone Nnmber: S71-0O10 ��`
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.r1C6eda1ldDatt: Z�i�-12-06 . 11:00:00
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ACIION 1�'�,�ty:l���1�6SZ�!lkAv�e.te.�t�sy ,��
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erertea by: wenay Hiatc Date e�e�sa: � 2v l`1-11-z9 `
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ACTION TAKEN: . �
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Status: In Progress �p�tt�r Has Been r,
Coututed
Date Completed: Completed by:
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• City of Fridley
Water Department � � � � �
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
t/we hereby authorize the City of Fridley and/or i�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 C'ity code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb siop box and service 1ine. fn understand t am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)
Name: Address �� �� �+'�
Phone Number Date «' �' ' � �
Signature Witness Signature
OLD METER# ���S� �� ` SIZE & STYLE(Circlel
OLD READING 0�Ce 4�o�� � � 5/8" HEX
NEW METER# `f /�� �l�i� i 1" HEX
NEW READING � 'r4;% ELIPTICAL or HEX
ERT# ��� � �g 7S� 2" ELIPTICAL or HEX
FRlDLEY CIT1!CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINIST'RATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
4�2.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line wnnecting the existing municipal system and arry house or bu�ding for which the
application is made,the owner or wMractor shall 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 has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting 11ne until an inspection has been made and such connection and the work incident thereto has 6een approved by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTiON
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 senrice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be Itable for all 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 maintenance 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 annuaily by an administrative poliry. It shall be the responslbility of the appiicant,
owner,occupant o�user to perForm standard maintenance of the sewer service line from the premises to the main including debris clearing 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 of the land or properly. (Ref 638,1156,1191)
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