Meter Swap �
Request Number: 12816
Public works Division
Service Request
Problem Addreas: 1581 73 1/2 A�e Requested By: Harold Holmstrom
Deps�rtmeat: WATER .A�resa: 1581 �3 1/2 A�
Fridicy,MN SS432
Problem/Isaue: INSTALL AMR METER P6one Number: 612-940.3862
ScheduledDate: 2017-01-13 � Schedaled'Iime: I0:30:00
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AC'IiON NEEDED:Inst�ll AMR
Crentedby: BcthKondrick DNe Cre�ed: 2017-01-10
ACTION TAI�N:
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st�ns: In Progress sat�nittor Ha.se�a �,
Coatuted
Date Completed: Completed by:
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City of Fridley f q �/
�• � Water Department � o l � l D
6431 University.Avenue NE
Fridiey,MN 55432 �c� 3—�1Ja-�pc�ti)
763-572-3566
1/we hereby authorize the City of F�idiey and/or its employees to do what is necessary to
replace the water meter. t 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�ty 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 1 am also required
to obtain a pe�mit prior to any work,if necessary.
FINAL METER READIN ZZ� � �fZ�
�(o d meter)
( 1
Name: � Address � � �� i � � /'L
Phone Number-�aG/—��- �—�� � Date ' ~ � `� � Y �
��-'.� �/
Signature ;.� _� . Witness Signature
OLD METER#__ '"I � � `� l,/ b�
OLD READING ?i��� ��
NEW METER# " { 1��� ��
NEW READING O
ERT# ���� �
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 municipal system and any house or building for whlch the
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shall be unlawful to wver
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Crty as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the applicant,owner,or ocwparrt or user of such premises shall 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 properly 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. R shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service wrb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or properly. (Ref 638,1156,1191)