Meter Swap ,
, Request Number: 15171
Public works Division
Service Request
Problem Address: 36 70th Way Requested By: Robert
Department: WATER Address: No adc�ess provided
ProblemlIssue: INSTAL,I,AMR METER Phone Number: 571-911 S
SchedWed Date: 2017-05-08 Sc6ednled'Ilme: 11:30:00 a
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AC7ION 1vEEDED:
Created by: We�xly Hiatt Date Cre�tted: 201?-0S-OS
ACTION TA[CEN: �
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Status: In Pro�ess Sabmitter Has Been �,
Contacted
Date Completed: �„ � ..,� Completed by: ��t`-e
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City of Fridley ��,�j C�v�
Water Department ��
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
�1We hereby authorize the City ofi Fridiey and/or its employees to do what is necessary to
replace the water meter. 1 unde�stand that the property owner is liable for the water line trom the main to the premise and all interior
plumbing. (Per�ty code 402.06) i aiso hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to inctude,but not lim�ted to valves,piping,walls,floors o�the wrb stop box and service li�e. In uaderstand I am afso required
to obtain a permit prior to any work,if necessary.
FINAL METER READINf(old meterj `� � �
Name• ��/� Address �
Phone Number V� � ^ Y�� `J Date � � � ~ � `
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Signature Witness Signature
OLD METER# ����� ���
OLD READING V �� ` `�� �
NEW METER# � I��o���U
NEW READING �
ERT# � I�;� I1 t�o
FRIDLEY ClTY CODE
CHAPTER 4Q2.WATER,STORM WATER AND 5ANITARY SEWER
ADMINISTRAT{ON
(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
application is made,the owner or wntractor shail be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. Ahe�such connection has been made,the Water and Sewer Department shall be notified. it shail be unlawful to cover
any conneding line until an inspection has been made and suth connection and the work incident ihereto has been approved by the City as a
proper and suitable connection.
402.06 REDAIRS AND MAINTENANCE TO CONNECTtON
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 service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of wch premises shali be liable 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 shalt be charged for the costs of the maintenance andJor
repairs,including necessary street repairs at a rate set annuafly by an administrative poliry. It shall be the responsibility af the applicar�t,
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 remai�s above the finished
grade of the land or property. (Ref b38,1156,1191}
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�ity of Fr�.dley �. i
' Water Deoartment
Address 3 6 �0'�'�, 1,t/� '
Name_ ���� �EU(`'�S��tt-i�v`
Date � o�" � p�-' � � �.
Old Meter Number � '
Old Meter Reading
Replacement No: ���,b�g a, �
0
Replacement Reading�
Replacement Make �r-'
Remarks: �
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Signed �.�;��