Meter Swap ,� Request Number: 12844
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Public Works Division
Service Request
Problem Addreas: 1390 76th Ave Requested By: Gvuen
Department: WATER Addreas: 1390 76th A�c
Fridley,MN 55432
Problem/Isaue: INSTALL AMR METER Phoce Number: 763-784-1a43
Seheduled 2017-01-20 Sc6ednledll�: 01:30:00
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AC'IION NEIDED:install AMR
Created by: Beth Kondrick Date Cre�ed: 201�-01-12
ACITON TAi�N:
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Status: In Progress �bmitter H�s Be�n �.,
Coutacted
Date Completed: Completed�y:
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City of Fridley � � `�� ( � �,�
Water Department S�3y���4�
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. 6431 University Avenue NE ���� -�
Fridley, MN 554�2
763-572-3566 '
�/We hereby authorize the City of Pridley 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 interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to vaives,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)�� ) � ( �
Name: �S U" �� Address I� `� ��� �
PhoneNumber�CJV ��i.J l' �-l� Date �� (J�+ L�
Signature �� Witness Signature
OlD METER# ���� �� � �
OLD READING . Z� � ! V
NEW METER#_ `� 1,�� 1 "
NEW READING_��
ERT#SU �CJ� � 1�v��
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 arry house or buiidit�for which the
application 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 li of this Code. After such connection has been made,the Water and Sewer Department shalt be notified. It shalt be unlawful to caver
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
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 service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
repuired to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests mair�tenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative polPry. It shall be the responsibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris tlearing 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 ftnished
grade of the land or property. (Ref 638,1156,1191)