Meter Swap Request Number: 12861
Public works Division
Service Request
Problem Address: 1444 76th A� Requested By: J Arney
Departmcnt: WATER Addresa: 1444 76th Atie
Fri�ey,MN 55432
ProMem/Issue: INSTALL AMR METEIi Phone Number: 763-783-3634
3c�eduled Date: 201?-01-19 � Sched�led 11me: 09:00:00
: '�G
ACTION NEEDED:
i
Created by: Beth Ko�rick Date Crerted: 2017-01•13
ACTION TAI�Nt
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Statua: In Pro ss subm�aer xas Bden �.,
� Comtacted
DAte Completed: � .... � �j,.,., '� Coa�eted by: � �
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�o�or rreaoey
Water�epartrnent � 03 .. �'�� ,��(� -- (� �
6431 University Avenue NE
. Fridley, MN 55432 � r� �� f �
, 763-572-3565 U �0
1/we hereby authorize the City of Pridley and/or its emptoyees to do what is necessary to
repiace the water meter. I understand that the properry owner is liabie for the water line from the main to the premise and all interior
ptumbing. (Per City code 402.06) i also hold the City of Fridtey and/its employees harmtess#or eny damages tFtat may occur while doing this
operation. This to include,but not Bimited to valves,piping,walls,floocs or#he curb stop box and service fine. in understand 1 am also required
to obtain a permit prior to any work,if necessary.
FifVAL METER READING(ald meCer)�,��l._.Ic L l-✓
Name: �1 ��e"Y`Y�y Address � ��i 1 �(.9� �J"e
Phone Numb� ��3 6�3�� J�✓-1 Date �J ' `_ ��
ignature 4YFts�ess Signature �'
OLD METER# � � �� � �
OLD READING_ v � i � t�
NEW METER# � ( � � v� �7
NEW READING �
ERT# � �� U� C� q � .
FRIDLEY CITY CODE
CHAPTER 402.WATER,570RM WATER ANO SANITARY SEWER
ADMiAIISTRATtON
(Ref Ord Pio 113,464,565,566,629,638,662,922,988,1144,115fi,1191)
402.5 PERMtT FEE
Prior to constructing or repair of any water of sewver lir�cannecting the exisfing municipai system and arry house or buifding for which the
application is made,the owner or cor�tractor sha(1 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 Department shall be rtaCi�ied. It shalt he un4awful to raver
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 su�table connection.
402.06 REPAlRS AAID MAfNTEAIAMCE TO COIMNECTION
After the initial rnnnection has been made to the water service curb stop box or the sewer lead at tfie property line or a water service lead has
been extended to the property line for connection,the appiicartit,owner,or accuparit or user of such premises s6a11 be liable for ali repairs
required to any water line and sewer tines necessary for connection of the premises from the main to the premises, if the property owner
requests mairrtenance sanrice or repairs be performed by the City,the proper#y owner shail be charged for the costs of the maisrtenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. it shal{be the ressponsbility o�f the appficarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the prem+ses to ihe main including debris dearing or
root cutting and to ma+rrtain the water service curb stop box for operability and at such height as wili ensure that it remains above the fi�ished
grade of the{and or property. (Ref 638,1156,1191)