Meter Swap I :� { '
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c�n or
Fridley
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��uest Number. 17338�
Pub�.;Works I)iv�ion �
� Servke Rae�at
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Preble�Address: 1682 68th A� Reqeested Hy: Teresa o�3�
Department: WATER Addre:s: No addraaa provided P
Problem/Iss�: INSTALL AMR ME1ER Pirone Number: 571-0010
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Sche�tded Date: 2017-12-07 ' ,^,.,t Scl�de�1ime: � 10:00:00 ' �
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City of Fridley �
Water Department
6431 University Avenue NE � �.�,�IJ�'� �
Fridley,MN 55432
763-572-3566
ljwe hereby autho�ize the City of Frtdley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is IiaWe for the water line from the main to the premise and all irrterior
plumbing. (Per City code 402.06) 1 alsfl hold the C'ity 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 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oMd meter) ���� 5 a�o
Name• l V C. i� Address tV V� `�' V�
Phone Number �� � � �� �� Date � � � � �
Signature Witness Signature
OLD METER# �� � � W�� SIZE & STYIE ICirclel
OLD READING CX/�`� w ��� 5/8" HEX
NEW METER# � I� / v�� a 1" HEX
NEW READING � 1' ELIPTICAL o� E
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ERT# �� �L� � a� 2" ELIPTICAL or HEX
FRIDLEY CITY CODE
CHAP'TER 402.WATER,STORM WATER AND SANITARY SEWER
ADM{NISTRATION
(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 connecting the existing municipal system and any house or building for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notlfied. It shall be unlawful to cove�
any connecting line untii an inspection has been made and such wnnedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MA{NTENANCE TO CONNECTION
After tfie initial connection has been made to the water servlce curb stop box or the sewer lead at the property line or a water sendce lead has
been extended to the property line for connection,the applicant,owne�,or ocwpant or user of such premises shall be liable for ali repairs
required to any water line and sewe�lines necessary for connection of the premises from the main to the premises. lf the property owner
requests maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the mai�rtenance and/o�
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. It shall be the responsi6ility of the appiipM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris�tearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land o�property. (Ref 538,3156,1191)
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