Meter Swap . �
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z' �in af
Friclley
R�quest Number: 17324
P�ic worka il�iv�iun
Servtce R�c�est
1�00
Proaem A�ees: .•1�69th Ave Reqn�sted By: Tarasa or 3�h�a
Departmeut: WA1ER Addr�a: No�css prpvid�d
- ProMemliss�: IN5TALL AMR METER Flane Nnmber: S'71-0010
Schednled Date: 2017-12-04 Schedded 1lme: 08:00:00
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ACITON NEEDE,I�ti011tlw'����i�M!Ib�•���cy
Crexted by: Wan�+Hi�t Date Cteated: 2017-11-29
ACIION TAI�N: �� �
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StAtus: In Progress 5ubmitter Haa Beee r.
Contacted
Date Completed: Completed by:
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City of Fridley
Water Department
6431 University Avenue NE ���f�� 3 �j,�-j�
Fridley,MN 55432
763-572-3566
Ijwe hereby authorixe the C'�ty of Fridley andjor its employees to do what is necessary to
replace the water meter. t understand that the property owner is liable for the water line from the main to the premise and all inter�or
plumbing. (Per City code+402.06) 1 also hold the City of Fridley and/its empioyees harmless for any damages that may oca�r whNe doing this
operation. This to include,but not limited to valves,piping,walls,floors or the cur6 stop boz and service line. In u�derstand 1 am also required
to obtain a permit prior to any work,if necessary.
F{NAL METER READIN6{o!d meter)
Name: Address ���v '�� (�
Phone Number Date 1�7—��
Signature Witr�ess Signature
OLD METER# ��� ! �� SfZE & STYLE(�rc{e)
OLD READING ��S�� ^7 C� 5/8" HEX
IVEW METER# "1 / `1' ! `�D� C,� " HE
NEW READING D 1�4" ELiPTICAL or HEX
ERT# �a �2 "'1 � $� � 2" ELfPTICAL or HEX
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY 5EWER
ADMINfSTRATION
(Ref Ord No 113,464,565,566,629,638,652,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer(ine connecting tfie euisting municipal system and any house or building for which the
application is made,the owner or contractor shaii be required to obtai�a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 aF this Code. After such connectfon has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line untii an inspection has been made and such connection and the work incident thereto has been aqproved by the City as a
proper and suitable rnnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to tbe water service curb stop box or the sewe�lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for ail repairs
requi�ed to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the prcperty owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. it sfiall be the responsibility of the appltprrt,
owner,occupant or 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 property. (Ref 638,1156,1191)