Meter Swap , Request Number: 12826
Public Works Division
Service Request �
Problem Addreas: 1611 73 1/2 Ave Requested By: Su�me Nietsen
Department: WA'lER Addres�: 1611 73 1/2 Avet�ue �
Fridley,MN 55432
Problem/Iasne: INSTALL AMR METER Phone Namber. 'I63=780-g018
SchednledDate: ?2a17-01•19 Sc�edaled'ISree:
a R� � , �N'1
ACIION NEEDED:
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Cnated by: Beth Kondrick Date Createds 2017-01-11
AC"TIOrI TAI�N: c� ,
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Stat�: •In Progress Sabmitter Has Beea �
Contacted
. . . . . � . 3Y`.�.. . � . .. . . . ..
Date Completeds �^— � 1..- ,� Complcted by:
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City of Fridley �� �L���
Y Water Department � /
` - 6431 University Avenue NE >�rJ� 1
Fridley, MN 55432 �J �JS�'
763-572-3566
I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all irrterior
plumbing. (Per City code 402.06) 1 also hold the C'ity of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � L � ! �
Name: �V120.�R�e. ��� �S�'�Address "�JIl� '� �I 73 /l2 Wa�f
PhoneNumber � C �3 —'�� `�(�7�Date ��� ` 1 ^ � L
._.
Signature Witness Signature
OLD METER# ��Cf� � C ! 7
OLD READING � � r� / ��
NEW METER# "t1 I� ����
NEW READING C�
ERT# � �J V V � � lJZ
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing mu�icipal system and any haise or building for which the
epplication is made,the owner or contractor shali be required to obtain a permit for such connection,and shall pay a permit fee as p�ovided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notitied. It shall 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 connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTtON
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 servke lead has
been extended to the properly line for connection,the applicant,owner,or occupant or user of such premises shali be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests malntenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annualiy by a�administrative poliry. It shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main i�cluding debris clearing or
root cutting and to maintain the water service curb stop box fo�operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)