Meter Swap r y� ,
E`�,�:''
Request Number: 12332
Public works Division
Service Request
Problem Address: 841 73rd Avenue Requested By: Larry Hoekstra
Department: WATER Address: g41 73rd Avemie
Fridley,MN 55432
Problero/Lcsue: INSTALL AMR METER Phone Number: 612-802-5950
Scheduled Date: 2016-12-14 Scheduled'i9me: 02:00:00
(;11� G .= 0
AC"ITON NEEDED:Install AMR
Created by: Beth Kondrick Date Created: 2016-12-02
ACTION TAI�N:
....................................mm�tn.�-4�_���..�-.........___.............:�'�1Z._.................__-_._.__................______..........................____.._......___..__......_._.__....._.___..______
Status: In Progress Submitter Has Been �
Contacted
Date Corapleted: �2� �� —�� Completed by: ,,� ��
' �'f`�'�i �"""'"'.
�`
!
� S � � � 3 �
City of Fridley
Water Department ��
6431 University Avenue NE `��� -S� a"3���
Fridley, MN 55432
753-572-3566
I/we ��'�/ �U� ��►�'✓��-- hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water m er. 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) I also hold the City of Fridley and/its employees harmless for a�y damages that may occur 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 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) l ��" � �O
Name: l.�r�/ ��'��.�-� �l. Address v�� ��r� f""`�
Phone Numbe� i�'� V"l7�"59 5 a Date '�Z �" �� � l �
'�-Signatur Witness Signature
OLD METER# �����►'d'"`�� � t� t � / ��
OLD READING � I� d� 6�
; ,,,.::;
NEW METER# �� l I�� ��_
NEW READING �
ERT# � � �3 ! �� � U
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and am house o�building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided Yn
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. it shall be untawful to cover
any connecting fine urrtil an inspection has been made and such connection and the woric incident thereto has been approved by the C'�ty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
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 the property line for connection,the applicant,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water line and sewer fines necessary for connedion of the premises from the main to the premises. If the properry owner
requests maintenance service or repairs be performed by the City,the property owner shail be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali be the responsibility of the appllcant,
owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main including debns dearing 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 finished
grade of the land or property. (Ref 638,1156,1191)