Meter Swap Request Number: 12554
Public Works Division
Service Request
Problem Address: 1415 76th Ave Requested By: Samuel Tones
, Department: WA1ER Address: 1415 76th A�
Fridley,MN 55432
' Problem/Issue: INSTALL AMR METER Phone Number: 612-490-2149
Schednled Date: 2016-12-27 Scheduled'Iime: 11:00:00
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ACl'ION NEEDED:Install AMR•far , °meter,per Sandi H.
Created by: Beth Kondrick Date Created: 2016-12-23
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ACTION TAI�N:
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Status: In Progress Snbmitter Has Been r,
Contacted
Date Completed: �� �' �,�,-.. I,� Completed by: � r
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' - City of Fridley 3�3- Jr 0 3 ��� fl
Water Department � s
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 u�derstand 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 a{so fiofd the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not timited to valves,piping,walls,floors or the curb stop box and service line. la understand I am also required
to abtain a permit prior to any work,if necessary.
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FINAL METER READING(old meter) �� �� �� �
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Name: � � 5 Address � ` �� �� 1\w
Phone Number �-�2 — -L ` ''��l � l Date `�✓ � t"" 1��
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Signature Witness Signature
OLD METER# � 4�� �� ✓�
OLD READING '�`� � � ��U
NEW METER# �' ` `� ����
NEW READING n
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FRIDLEY CITY CODE
CHAPTER 4Q2.WATER,STORM WATER AND SAN{TARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
40Z.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connectir�g the existing municipal system and arry house or building for which the
applicatioa is made,the owner or torrtractor sfiaU be required to obtain a permit for wch connection,and shall pay a permit fee as provided ir�
Chapter 11 of this Code. After sucb connection has been made,the Water and Sewer Departmer�t shail be notified. tt shali be unlawful to co�r
any connecting line until an inspedion has been made and such connection and the wo�lc incident thereto has been approved by tfie City as a
proper and suitable connection.
402.06 REPAIRS AND MA{NTENANCE TO CONNECTION
After the initlal connection has been made to the water service curb stop box or the sewer lead at the property line or a water service{ead has
been extended to the property line for wnnection,the applicant,owner,or occupant or user af such premises shaif be liabie fw ail repairs
required to any water lirte 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 City,the property owner shatl be charged for the costs of the malMenance and(or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the respansibility of the app4icant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from tfie premises to the main 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 it remains above the finished
grade of the land or property. (Ref 638,1156,1191)