Meter Swap ' Request Number: 15340
Public Works Division
Service Request
Problem Address: 146?1 st Way Requested By: Barb Bergseth
Department: WATER Address: No address pcovi�d
Problem/Issue: INSTALL AMR METER Phone Number: 763-572-0669
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Scheduled Ds�te: 2017-OS-31 �iEheduled 13me: 09:00:00
ST
Acnorr r�EUEn:
Created by: Beth Koadrick Date Created: 2017-OS-15
ACIYON?AK�N:
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Status: In Progress Submitter Has Been r. �
Contacted
Dste Completed: ��, ��! �y Completed by: ���
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� City of Fridley � � , /�� , /
Water Department �� ��
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
��W� hereby authorize the City of Fridiey andJor its empioyees to do what is necessary to
repiace the water meter. t understand that the property owner is liable for the water line from the main to the premise and alf interior
plumbing. (Per City code 402.06} I aiso hold the City of Fridley andiits employees harm{ess for any damages that may ocsur wfiile doing this
operation. This to include,but not limited to valves,p+ping,wafls,floors or the curb stop box and service line. tn understand 1 am also requlred
to obtain a permit prior to any work,if necessary.
FINAL METER READING{old meter� ���� �� O
Name• "� ���� Address �� `r � � 5� W�
Phone Number 6�✓ 'a���( "�v���Date_ � � � r� ��
Signature ��K/ Witness Signature �
OLD METER# ����1���
OLD READiNG ���� ��v
NEW METER# ���� "' ' ��
NEW READiNG �
ERT# � � oCo� �� � �
FRIDLEY CITY CODE
CHAPTER R02.WATER,STORM WATER ANO SANITARY SEWER
ADMINISTRA710N
(Ref Ord No 113,454,565,566,629,53$,662,922,988,1144,1156,1191)
+t02.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the euisting munkipal system and any house or buiiding for whicfi the
application is made,the owner or contrador shalf be required to obtain a permit for such connedion,and shaH pay a permtt fee as provided in
Chapter 11 of this Code. After such connectian has been made,the Water and Sewer Departmerrt shall be�ot�ed. tt shall be unlawfui to cover
any connetting li�e untii an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitabie connectioa.
402.06 REPAIRS AND MAINTENANCE TO COWNECTION
After the initiai 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!he property line for con�ection,the applica�t,owner,or occupant or user of such premises shall be liabfe for ail repairs
required to any waier line and sewer lines necessary for connection of the p�emises from the main to the premises. If the property oarner
requests maintenance service or repairs be performed by tfie City,the property owner shall be charged for the rnsts of the maintenance andjor
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. it shal!be the responsibility of tfie appticar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from tfie premises to the main i�duding debris dea�ing or
root cutting and to maintain the water service curb stop box for operabllity and at such height as will ensure that it rert�ains above the finished
grade ofi the land or property. (Ref 638,1156,1191J
Requ�t for�envi� Re�ort
City af Fridle�I
F�+�rer��: �-12-5�74 C���: 8,t2'4l�12
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