Meter Swap #
� Request Number: 13123
Public works Division
Service Request
Problem Address: 1362 76th Ave Requested By: Jeff Walzack
Department: WATER Address: 1362 76th Ave
Fridley,MN 5543Z
Problemlls:ne: INSTALL AMR METER Phone Num6er: 612-889-2274
Scheduled Ihte: 2 -02-10 Schedaled Time: 02:00:00
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ACTIOri NEEDED:
Created by: Beth Kondrick Date Created: 2017•01-27
ACIION TA�N:
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Status: In Progress Sabmitter Has Been r
Contacted
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Date Completed: �_ t� — �� Completed by: ��� �
watea-��r�a�reent �� ���
�431 dOrtiv�a-si Avera�ae N�
Frielley, MN 55432
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� 753-572-3566 �C;� _�c;3 y 3 L -�' �
!/we her�by authorize the Cn.y o#Fridley and/or its empioyees to slo whafi is necessaey to
replace#he water meter. 1 understand ti�at the property owner is liabte for the avater line from the main to the premise and all irnerior
plumbing. (Per C'rty sode 402.06� i a(so hold the Crty of Frtdley and/'rts em}aloyees harmless for eny damages tteat may occur while doing this
operaYion. This to anclude,bufi not Bim�ted to valves,piping,walls,#loors or the curb stop boz ancl service line. In vnderstand i am also requir
to obtain a permit prior to any�rorlc,if necessaey.
FIAtAL METER READING�ok[mefier) �V� � L O
Name: .,J�T �'�,�,�o�. Address �,��_ ��+' � �
Phone Rtumber �,�Z-— �� i"' 1 d-'�— I Date ��' �'� � ��
Signature ��
Witness Signature
OLD METER#i V� � � C� ���y�,
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OLD READItYG �/ �J���
NEW MEfER# l,� l,� � 1 �D
NEW READfNG v
�R�# � T g I 2 3 c�U •
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAN{TARY SEWER
ADMfN ISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,i191j
402.5 PERMIT FEE
Prior to constructing or repair of ar�y water of sewer line connecting the exiseing municipal system and arry house or buiMing for which the
application is made,the oarner or contractor sha(I be required to abtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 af this Code. After such connection has been made,the Water and Sewer Departmerit shall be n�ed. tt shati be uniawful to crnre
any tonnecting line until an inspection has been anade and such connection and tha wor�c inciderrt thereto has been approved by the City as a
proper end suitabte connection.
A02.06 REPAIRS ARID MAtPl7'EtMpMCE TO CONIYECTIOM
After the initial connection has been made to the water service curb stop 6ox or the sewer lead at the property line or a rrater service lead#ws
been extended to the property line for connection,the applicarrt,owner,or accupar+t or user of such premises sf�aq be Nable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. tf the property owner
requests mairrtenance senrice or repairs be performed by the Crty,the property owner shali be charged for the costs of the maiMenarr�and/or
repairs,including necessary street repairs at a rate set annuai(y by an adminitstrafive policy. tt shall be the responsibility of the applicarrt,
owner,occuparrt or user to perform standard mairrtenance of the sewer service tine from the premises to the main 9�clu��debris dearing or
root cutting and to maintain the water service sa�rb stop boK for operability and at such height as will ensure that it remains a6ove the finished
grade aF the land or properl.y. (Ref 638,1156,1191)