Meter Swap , - � , 1
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FMai�y
Request Number: 17325
Publ[c Worl�Dlvis�n
Servlc�Request
Prohle�Addtess: 1570 69th Avie Reqneated By: Teresa or S�
Department: �VATFlt A�d�resa: No ad�ess provided
Problem/Iea�e: INSTALLAMRMEIER Pho�Nnmber: 3�1-OU10
Sc�ednled D�e: 2017-12-04 Scl�tled't1me: 09:OO:W
`-C� YY'1
ACIION N��/0 0lRc�lit 1632 f9�A�ts*e�l�y
Created by: W�ndy Hiatt D�te Created: 2017-11-29
ACIION TA�N: �L )`
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Status: In Progcess Sabtnitter Aaa�een r
Contncted
Ihte Completed: I��� �� Compieted by: ����
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Ci of Fridie
Water Depart ent ^���"��)��
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
1/M►e hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the yxoperty owner is liable for the water line from the main to the premise and all inte+ior
plumbing. (Per City code 402.06) I also hold the City of F�idley and/its employees harmless for any damages that may occur whlle dang this
operatio�. This to inciude,but not{imited to valves,piping,walls,floors or the curb stop boz and service line. tn unden�tand f am also required
to obtain a permit prior to any work,if necessary.
FINAI METER READIN6(o{d meter) v" � � �� � `� O
Name: J ����- Add�ess 1 � �a � L � ���
Phone Number ��� v�l � Date ��� � � L l
/"_�_
Signature Witness Signature
OLD METER# ��a� 33 `�'a-- SIZE & STYLE (Circie)
OLD READING o'�'Y i ��� vV 5/8" HEX
NEW METER# ��� / ���O 1" HEX
NEW READING `� �1�'j EUPTICAL or HE
C✓ ��
ERT# ` ��—/ / � � � 2" ELIPTICAI or HEX
FRiDLEY CfTY CODE
CHAPTER 4U2.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(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 house or buliding for which the
application is made,the owner or contractor 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 unlawfu!to cover
any connecting line umil an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTEPfAPlCE TO COMNECTfON
After the initial connection has been made to Che water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connedion,the applicant,owner,or occuparrt or user of such premises sfiall be Ifable for ali 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 shail be charged for the costs of the maintenance and/or
repairs,incfuding necessary street repairs at a rate set annually by an administrative poliry. ft shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris clearing or
root tutting and to maintain the water service curB stop box for operability and at such height as wiii ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)