Meter Swap �
� Request Number: 15438
Public works Division
Service Request
Problem Address: 149 76th Way Requested By: Jerry Matson
Department: WATER Addresa: No address provided
Problem/Issue: 'IURN WATER ON/OFF Phonc Number: 608-347-0795
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Sciceduled Date: 2017-05-01 Scheduled'ljme: 09:00:00
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ACTION NEEDED:��ttf�ar i�r vs�vic r�peir.Pltanbs�'will be there betwce�9-11 am:T�t�;�st ,
°-�;�QUaroa:B�ing A1vfR aieter�vith at�d insiall at tl�same time if possible. . ` '
'
Created by: Beth Kondrick Date Crerted: 2017-OS-18
' ACTION TAI�N:
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Status: 1n Progress Snbmitter Haa Been �.,
Coutacted
Date Completed: Completed by:
Hours
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City of Fridley
�ater Degartment
6431 University Avenue NE
� Fridley MN SSA�32
- (763) 572-3561
Uwe hexeby authorize the City of Fridley and/or its
employees to do what is necessary to shut offthe water at the curb stop box. I understaad
tha.t the progerty awner is liable for the water line firom the main to the premise• (Per
City code 402,Q6) I also hold�.e City of Fridley and/or its employees haimless for any
d.am.ages that ma.y occur while doing this operation. This to include,but nat limited to,
sod,yazd,laudscaping,trees, shrubs,d.riveways,sidewalks ar the cut'b stap box aud
service line. i understan.d I am.alsa required ta abtain a pemait prior ta an.y wor�
Name: Address:
Phone Number: Date:
Signatare:
T�litaess Signature:
��RI�}LEY CITY CODE
CI-tA.PTER 402.WATER,STORM WATER AND SANTSARY SE�VER
ADMllYISTRt�.TIUN
(Ref O�rdNo 113,464,565,56b,629,638,662,922,988,1144,.1156,1191)
4U2.05. PERMIT I+`�.E
Prior to construcxin.�or regair af any water or sewer line connecting the existmg municipal system sud�y
honse or bw7.dnug for whic�the applicxiion is made,the ownet or comtractor shall be required to obtam a
pemiit for such crnmection,and shall pay a.penmit fee as provided in Chapter 11 of tbis Code. Atter such
connection has been made,the Water and Sewer Departm.ent shall be notified. It sl�ati be umlawfi�l to cover
any cannectin.g line until a�mspection has been made and such connects.on an.d 1�e wozk incident thereta
has been aggroved by the City as a.propes am.ct sr�ilable coimection.
�oz.o�. �P.�s �,rrm m�,nv�+r�.vcE Ta cornvECTT�oN
Af�er the initial connection�as been made to the water service curb stop b�x ar the sewer lead at the
pmperiy]zne or a water service or sewer lea.d has been extended to the proPertY lme for coamection,the
applicant,ov�mer,or the occupant or user of such premises shall.be Iiable for all repairs requaecl to any
water]in:e and any sew�er lines necessary for canneckion of the premises frvm the m�to t�e prennises. If
the property owner requests maintenan.ce serv ices or repairs he per�ormed by the City,the properiy uamer
sball.be charged for the costs of the maintenan.ce aad/or repairs,in.clud'mg anY necessaYY s�t TePan's,at a
rate set a�.ually by an administrative golicy. It shall be the responsrb�i.ty of ttie applicaurt,qwner,occnpant
or user to'perform stand�rd mamtenance of the sewer sezvice l�uue from i�e prem.ises to ttte main in.clucling
d.ebris c1�or root cutt�g and to maintaiu the water s�rvice ciab stop bog for opeiab�.lity snd at such
heig�.t as will ensute f3�t it zemains above the fmisl�ed grade of the land or propertp: (Ref b3�,1156,1291�
, � City of Fridley 3v�'`��f�3� �'��
Water Departrnent
6431 University Avenue PIE S� � (,�,��j�
Fridley,MN 5�432
763-572-3566
<<`"�e hereby authorize the City of Fridley 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 interfor
plumbing. (Per City code 402.06) I also hold the City of Fridiey and/its employees harmless for arry damages that may occur wh�le doing this
operetion. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj �����:J�
Name: Address � r�� `����'� /
Phone Number p� ''�V"r 1, —'�
! � __._..._.__..._. .
Signature '` Witness Signature .
OLD METER# ���� �
OLD READING ������
NEW METER#__ `'f,���(p t��l�
NEW READING �
ERT#_ � �.��- L���
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 co�structing or repair of any water of sewer line connecting the existing municipa!system and any house ar Iwitdh�g for which the
application is made,the owner or contrador shall be required to obtai�a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shall be notified. It shail be unlawful to corer
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 witable connection.
402.06 REPAfRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water senrice 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 occupaM ar user of such premises shatl be{iaWe for all repain
required to any water line and sewer lines necessary for conneetion of the premises from the main to the premises. If the property owner
requests mairrtenance service or repairs be performed by the City,the property owner shali be charged for the costs aF the maintenance and/or
repairs,including necessary street repairs at a rate set annua{ly by an administrative policy. It shall be the responsibii'�ty of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to mairrtain 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)