Meter Swap � Request Number: 15136
Public works Division
Service Request
Prublem A�ddress: 61 ?Oth Way Reqnested By: Ryan
Departme�: WATER Address: No ac�ress�ovided
Problem/Lssue: INSTALL AMR METER Phone Number: 612-741-6207
Scheduled Date: 2017-OS-OS Sc6cduled 1lmet 1030:00
�1�
ACTION NEEDED:
Crested by: Wendy Hiatt Date Created: 201'7-05-04
ACTION TAI�N:
.......___.........................__.�.___................1...�s-�-�.._.�r��.............................__... ____�_.___.______ M��___�____._
5tatus: In Progress Sabmitter Has Been �,
Contacted
Date Completed: Completed 6y:
5.'�.- � �
` � 3 - �� "1cP0 --as
' City of Fridley
Water Department ��� ���
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the C"�ty of Fridiey andjor its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
piumbing. (Per City code 4�2.06) 1 also hold the City of Frid{ey and/its employees harmless for any damages that may oca�r while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. in understand I am also required
to obtain a permit prar to any work,if necessary.
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FINAL METER READiN6(old meter�
(_l -' ���lk�" �l ,
Name• Address__Y,��
.�
Phone Number Date ��` �
Signatu�e ��. Witness Signature
OLD METER# �.1 �,,1_./�{ �C�S ' V
OLD READING ���O��
NEW METER# � t� (JV O`it
NfW READING �
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ERT#_ �[��� J LO� �`�['�'
Fai��EY cmr cooE
CHAPTER 402.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 af sewer line conneding 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 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 Departmerrt shall be not�ed. It shall be unlawfui to cover
any connecting line urrtif 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 MAINTENANCE TO CONNECTION
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 such premises shall be liabfe for all repairs
required to any water line and sewer lines necessary for connection of the premises f�om the main to the premises. ff the property owner
requests maintenance service or repairs be perFormed b1r the City,the property owner shall be charged for the casts of the mairitenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. !t shall be tfie responsibil'ity af tfie 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 cutting and to maintain the water service curb stop box fo�operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
. . .� G, Q�3
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" City of Fridley
Water Devartment
.., _ _
Address_;��_����
" Name d `i'�R,� �,� M�Al,.)
. Date �` �� -� _
�ld Meter Number_�� ���C.7 � G�,_o�'�""�`'I
old Meter Reading �v 4�
Replacement No. ������C7
' Replacement Read�ng �
Replacer�ent Make ���
Remarks• ����� !�'Z�-
, S igned '�v
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