Meter Swap . Request Number: 12851 � -
Public Works Division
Service Request
Pro�em Addreaa: 1320 76th Are Requested By: Rich McCoy
DepartmeM: WATER Addresa: No ad�ess pcovided
Prob[em/Is:ue: iNSTALL AMR ME'IER Phone Nnmber: 763-370•8132
Sc�dnled Date: . 2017-01-20 Schedaied T[me: 02:00:00
4 2 �.� �
AL.'lION NEEDED:
Cre�ed by: Wendy Hiatt Date Cre�ed: 2017-01-13
A�C110AT T.�i�N:
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Statue: In Progress Submitter H�t��e� C,
Coetactcd
Date Completed: � `'7 Coaydeted by:� ��
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City of Fridley
�l� � � C�`�
Water Department ��� d S� �3��-C�(
, 6431 University Avenue NE
� Fridley,MN 55432
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. 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 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(oid meter) ��Z� � v
Name: ��,�- �C�Y Address ��J r/�-' �� �
Phone Number (��3 `� ���"`87��-Date 1� � ^` �' L
Signature --"`r�_~�-""'—""""--------.. Witness Signature
OLD METER# ��� ✓ '�` v �Z--
OLD READING ���� �V
NEW METER# �� � f �� V.��
NEW READING �
ERT# � �� / LI � Y�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRA710N
(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 municipai system and any house or buildingfor whkh the
application is made,the owner or contractor shall be required to obtain a permit for such�nnection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shail be unlawFul to�ver
any connecting line until an inspection has been made and such connection and the work incident thereto has beeo approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC'1'ION
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 servkx lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shaN be IFaWe for a!I 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 maintenance service or repairs be performed by the�ty,the property owner shall be charged for the�sts of the mai�enana and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It 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 mai�including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that ft remains above the finished
grade of the land or property. (Ref 638,1156,1191)