Meter Swap � � � �
� �
c:rrs flf
Frisiley
Request Number: 17326
Pt�lic Worl�s Divia�n
Servk�e Ret�st
Probleffi Addrass: 1 S65 68�th Atic Requestad Sy: Tensa c�r S�nu�
Dep�rtmegt: WATER Address: No add�+sas provitied
Prablemllssae: INSTALL AMR ME1ER Pho�Number: S71-0O10
&Ledule$Iyate: 2017-12-04 ,� Se�edaled'A�e: 10:00:Ot?
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ACIION 1�3�D:E"iu-1�i o!l�cs w�1632 69th A��t ta�MC 1�ay
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Created by: Wcndy Hi�t Date Created: 2017-i l-29
ACIION TAKEN: ,
�v`s-�C l� � � �/2 -��-�`C',Z_____
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Status: In Progrtss ��her Ans Been r
Contacted
Dxte Completed: ia,. �� ''� Completed by: ���
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t 3a� - �� t ��� �- � �
City of Fridley �j � �j`� �
Water Department
6431 University Avenue NE
Fridfey,MN 55432
763-572-3566
1/+Ne hereby autfiorize the Clty of Fridiey and/or its employees to do what is netessary to
repiace the water meter. i understand that the property owner is liabie for the water line from the main to the premise and ali iMe�ior
plumbing. (Per C'rty code 402.06) 1 also hoid the City of Fridley andfits employees harmless for any damages that may occr�r while doi�g this
operation. This to include,but not{imited to vahres.piping,walls,floors or the wrb stop box and service line. In understand 1 am also required
to o6tain a permit prior to any work,if necessary.
FiNAI METER READING(old meter) ��� I � �v�
Name• Address l.� � � lS� � F„C�v �
`J� � ' ^•
Phone Number �� � v Date �� � ^ ` (
�_
5+8��� Witness Signature
OLD METER# �����-7 �� SIZE & STYLE(Cirde,�
OLD READING � t � � � ��� 5j8" HEX
NEW METER# � 1� i `�' v L v 1" HEX
NEW READING `-' 1'r� EIIPTiCA or HEX
/� � �
ERT# ��� � ��V� 2" EUPTICAI or HEX
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WA7ER AND SANITARY SEWER
ADMINISTRATiON
(Ref Ord Plo 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 municipa!system and ar►y house or buifding for which the
application is made,the owner or contrador shall be required to obtain a permit fo�wch connection,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. ft 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 Cit�r as a
proper and suitable connection.
402.06 REPAIRS AND MAlNTENANCE TO CONNECTION
After the initial cflnnection has been made to the water service curb stop box or the sewer lead at the p�operty lioe or a water senrice lead has
been extended to the property line fior connection,the applicant,owner,or occupent or user of wch premises shall be liable for all repairs
required to arry 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 sha{I be charged for the costs of the maintenance and/or
repairs,includfng necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the appiica�,
owner,occupant or user to perform standard maintenance of the sewer senrice line from the premises to the main including debris clearing 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 ftnished
grade of the land or property. (Ref 638,1156,1191)