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Meter Swap �� " �°�°`�`' "��. � City of Fridiey �� C� Water Department J 6431 University Avenue NE Fridley,MN 55432 763-572-3566 I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to repiace the water meter. 1 understand that the property owner is liabie for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City of Fridley andiits empioyees harmless for any damages tfiat may octur while doing this operation. This to inctude,but not limited to vaives,piping,walls,fioors or the curb stop box and service line. in understand I am also required to obtain a permit prior ta any work,if necessary. FINAL METER READIN6(old meter) � �� (/ / ! � � /� t � Name• Address ��d '1� l�J �"r'�`�' � ��/V Phone Number �b " 'r� � Date_,�,rJ�� 3 pZ Signature ' � Witness Signawre OLD METER# �� y�� OLD READtNG ��C�� NEW METER# �� NEW READiNG X✓ ERT# � �� ;>� �� FRtDLEY CITY CODE . CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRA710N (Ref Ord No 113,464,565,566,629,638,652,922,988,1144,1156,1191j 402.5 PERMIT FEE Prior ta constructing or repair of any water of sewer line conneding the existing municipal system and any house or buiiding for which the application is made,the owner or cor�tractor shaif be required to obtain a permit for such wnnection,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 he notified. It sha{I be uniawful to co+re+r�rr any connecting iine ur�til an inspection fias been made and such connection and the work inddent thereto has been approved by the City as a proper and suitable connection. . 402.06 REPA{RS AND MAtNTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the propertyt tine or a water servia lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shafl be liable for atl repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner requests maintenance service or repairs be performed by the C'�ty,the property owner shall be charged for the costs of the maintenance andJor repairs,including necessary street repairs at a rate set annuaNy by an administrative poticy. It shalt be the responsibility of the applicar�t, awner,occupant or user to perform standard maintenance of the sewer service fine from the premises to the main including debris dearing or root cutting and to maintain the water service curb stop box for operability and at such height as witt ensure that it remains above the tinished grade of tfie land or property. (Ref 638,1156,1191) REQUEST FOR SERVICE REPt?RT � CITY OF FRIDLEY Reference No. �t'{4�� Date: �--�� a Request Type: �� Entered By: Department: Citizen Name: Jv�► �.<�Y � ; :" Address: l�$' �� - '�''�� Phone Number: '7�f��-��"�� Schedufed Date: Property Owner: Location Detaiis: Request Details: Action Taken; �J�"i.�2. �.��. ." `��7-E � �'lh�t.. �.,, �i 11r1.�t"�- �IJ " (N 5"�'tA��t.� l�C-� �h.l�"^J � � �t-.-�� l��. ` - �---- , Responsible Person: Approver: . . , .. .. . . , . � . �. . �_ ,,;F.S�;,�. Completion Date: _ --17 Citizen Notified: � ` ��-� � �� f .:�