Meter Swap � Request Number: 12840
_____
Public Works Divis�on
Service Request
Problem Address: 1485 73rd A� Requested By: Timothy
Depsrtmeet: WATER Addre:s: No ad�es�provided
Aroblem/Iasne: INSTALL A1bIIt METER Pho�e Nwmber: 651-233-4580
Sched�ded 201 -01-18 � Sche�led 1lme: 01:00:00
ACIION NEEDED:
Cre�e�by: We�y Hiatt Dtte Crested: 2017-01-12
ACTION TAI�N:
�-��-�.���.�1��
��
��
Sts�tus: In Progress Sabmittzr Has Btcn �,
Coatacted
w�
Date Completed: �_ �� —^�,� Co�eted by: � ���
� � x
City of Fridley
- Water Department �-�� ��,��
� 6431 University Avenue NE ^�v�'
Fridley, MN 55432 �� � /
763-572-3566 S � �� �
1/we hereby authorize the City of Fridley and/or 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
plumbing. (Per City code 402.06) 1 also hold the City of Fridiey and/its employees harmless for any damages that may occur while doing this
operation. This to incfude,but not limited to vatves,piping,walls,floors or the curb stop hax artd service line. !n understand!am aiso required
to obtain a permit prior to any work,if necessary.
FINAt METER READING(oid meterj ���� ���
Name:�,1M O� Address � �� r� e
Phone Number ��I � � �— t� C7`�� e �� ���' `�
Signature ' INitness Signature �1
OLD METER# � l`++� ���(�
OLD READING ���� �� �
NEW METER# � 6 �' �� ��
NEW READING d
ERT# � v� V�� `��
FRIDLEY CITIf CODE
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�epair of any water of sewer line connecting the existing municipai system and any house or building for which the
applicatiort is made,the owner or contractor shall be required to obtain a permit for wch connection,and sMaU pay a permit fee as pro+raled in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. It shali be unlawful to cover
any connecting line until an inspection has been made and such connection and the work inadent thereto has been approved by the City as a
proper and suitable connedion.
402.06 REPAiRS AWD MANYTENANCE TO CONIYECTIOIY
After the initial connection has been made to the water service curb stop box or the sewer�ead at the pwperty Une or a water service lead has
been entended to the property line for wnnection,the applicaM,owner,or occupant or user of such prernises shall be liable for aii repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the properly owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged fo�the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. It shali be the responsibiUty of the applicaM,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debrts 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�inished
grade of the land or property. (Ref 638,1156,1191)