Meter Swap `� Request Number: 12719
Public Works Division
Service Request
Problem Address: 333 76th Ar+e Requeated By: Woodc:rest Pacsona�e
Departmeat: WATER A�dth�es:: 333 76th Ar�
Fridley,MN 55432
Probtem/Issue: INSTALL AMit ME'IER Phone Namber: �63-786-4914
Sc6eduledDatr. 2017-01-09 .� Schedaledlime: 07:30:00
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ACIION NEEDED:Install AMR
Cre�ed by: Beth Kondrick Date Cre�ed: 2017-01-04
AC'1ION T.,1�1V:
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Strtna: 1n Progress Sabmitter Ru Beea �
Cont�ted
Date Conpieted: Completed 6y: ����
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City of Fridley �� � �� �
Water Department
, 6431 University Avenue AfE ,
� Fridley,MN 55432 �jc��-5��5� ��
763-572-3566
�/We hereby authorize the City of Fridley andJor its emplayees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water tine 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
operatian. This to include,but not limited to valves,piping,walis,ffoors or the curb stop box and service line. lo understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)__�� (...,� �� � 33 —�(p�_
wame: b tll��� � dress ��.) ��i,��1 ��
Phone Number "—'� � ( D� �`'���
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i.�►�5ignature t.� Witness Signature A
OLD METER# (;�� ��� ��E�..-) I
OLD READING ��� ��O
NEW METER# �� � � L.���0�
NEW READING �
ERT# c�� V L/ `
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAN{TARY SEWER
ADMINISTRATIOAI
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,115fi,1191j
402.5 PERMIT FEE
Prior to constructing or repafr of any wate�of sewer tine conr�ecting the existing municipal system and arry house or buiiding for which the
application is made,the owaer or contractor shall be required to abtain 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 notified, it shai!be unlawful to cover
any connecting line until an inspection has been made and such connectioa and the worlc inadent thereto has been aQpro�red by the Ctty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water service curb stop box or the sewer lead at the property line or a water service Iead has
been extended to the property line for cos+nection,the applicarrt,owner,or accupani or user o#wch premises shall be liabie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the prem'�ses. If the properly owrrer
requests mairrtenance service or repairs be performed by the City,the property owner shaN be charged for the costs oF the mairrtenance andJor
repairs,including necessary street repairs at a rate set annuaily by an administrative qoliry. It shali be the responsibitity of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main includ�ng debris dearing or
root cutting and to mair�tain the water service wrb stop box for operabil'ity and at such height as will ensure that it remairu above tbe finished
grade of the land or property. lRefi 638,1156,1191)