Meter Swap � Request Number; 13065
Public works Division
Service Request
Problem Address: 1381 75th A�e Requested By: Walter Muyres
Department: WATER Address: No address provided
Problem/Issae: INSTALL t�1�Ilt ME1ER Phone Number: 763-784-5106
Schedaled Date: 2017-01-27 5chednled 11me: 01:30:00
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ACIION NEEDED:
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Created by: We�y Hiatt Date Createdt 20I7-OI-25
ACTION TA,I�N:
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Statua: In Progress Snbmitter Has Been r,
Contacted
Ds�te Completed: Completed by:
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4i/a�e�-�e�artvnent �'j� �� �� ��
5431 Universit�Avenue 9t1� � � T- (" �, i
Fridley,MN 55432 � L � � �� � �`/ " �- ` 1
763-5�Z-3556
• �j'''�e hereby authorize the Ciiy af Fridley and(or its em�ioyees to do what is necessary to
replace the wafier rneter. )understand that#he property owner is liable for the water line from the main to the premise and all ir�terior
plumbing. (Per C'rty code 4fl2.06) i also hold the City of Fridley and/its emptoyees harmless#or any damages that may occur while doing thts
operation. This to include,but not limited�o valves,piping,walis,floors or the curb stop boz and service line. In understand I am also require�
to obtain a permit prior to any wor�c,�f necessary.
FQVAL METER REAUt (d meter) � � { i J � � \ /
Name: �+ Address__i��� � �� ��Q.'–
Phone Num '�� "�� � p� �� ��"' 1�
Signature —�"'—'—" Witness Si�nature
OtD METER# 1�� �� ZO i�►J ln l- ' '
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OLD READtNG_�, �- �� � ��
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITI4RY SEWER
ADMINIS'TRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1i56,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing muniapat system and atry house or buiidir�for whic�the
appt�catian is made,the owner or corrtractor shail be required to obtain a permit for such connection,and shall 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. i#shall be unfawfial to crnrer
any connecting line until an inspectioa has been made and such connection and the worbc inaderrt thereto has been approved by the City as a
proper and suitabte connection.
402.06 REPk�IRS AND MAINTEWANCE TQ CONNECTION
After the initial connectio�has been made to the water service cvrb stop box or the sewer lead at the property iioe or a water�n�e lead has
been eutended to the property tine for connection,tbe appiicarrt,owner,or occupar�t or user of such prem�ses shatl be ItaWe for all repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. tf the property owner
requests mairrtenance seraice or repairs be performed by the C'rty,the property owner shaU be charged for the costs of the mairrtenance and/a
repairs,inciuding necessary street repairs at a rate set annually by an administrative poliry. It sfiali be the responsibility of ii�e applicarrt,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main inctudirig debris dearing or
root tutting and to mairrtain the water service curb sfiop box for operability and at such height as wili ensure tfiat it remains a6ove the finished
grade of the land or property. (Ref 638,1156,1191j