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Meter Swap / i � Request Number: 12405 Public works Division Service Request Problem Address: 7447 Able 5t Reqnested By: Rob Olson Department: WA'IER Address: No address provided ProMero/Issue: INSTALL AMR METER Phone Number: 651-600-6511 Scheduled Date• 2016-12-14 Schednled 1lme: 08:30:00 1 �.�s � c3 ACITON NEIDED: Created by: Werdy Hiatt Date Created: 2016-12-09 ACTION TAI�N: 1 � � ���.����-�,� _._ �..... Status: In Progress Submitter Has Been r, Co�actcd Dgte Completed: Completed by: I � � �� �- � � � City of Fridley Water Department - � 6431 University.Avenue NE . Fridley, MN 55432 163-572-3566 �/We hereby authorize the City of Fridley and/or its employees to do what is necessary to rep{ace the water meter. i understand that the praperty owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06j 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this operation. This to include,but not limited to valves,piping,walis,floors or the curb stop boz and service line. In understand i am also required to obtain a permit prior to any work,it necessary. FINAL METER READING(old meter) Name• pddress Phone Number Date Signature Witness Signature OLD METER# OLD READING NEW METER# NEW READING ERT# FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINIS7RATION (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 municipaf system and any house or building for which the application is made,the owner or cor�tractor shali be required to obtain a permit for such connection,and shali pay a permit fee as provided i� Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shail be unla�aful to cover any connecting tine urrti{an inspection has been made and such wnnection and the wo�lc incident thereto has been approved by the City as a proper and suitable 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 Ime or a water servtoe lead has been extended to the property line for connection,the applica�,owner,or occupant or user of wch premises shail be liabie for all repairs required to any water line and sewer tines necessary for connection of the premises from the main to the premises. If the pnoperly owner requests maintenance service or repairs be performed by the City,the property owner shall be c�arged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set annually by an administretive poliry. It shail be the responsibility of the applicant, owner,occupam 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 fos operability and at such heigfit as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) Ci of Frid{e �, Y L� � C��� - Water Department 6431 University.Avenue NE Fridley, MN 55432 �(�� �����J v-'l�.— 763-572-3566 ��� ���� �1We hereby authorize the City of Fridley and/or its employees to do what is necessary to rep{ace the water meter. I understand that the property owner is liable for the water line from the main to the premise and ali 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 valves,piping,walls,floors or the curb stop boz and service line. In understand 1 am a{so required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) �� ✓ ` O � v Name- ��,��" , Address� ����. J-1 Phone Number �! { OV''��� �ate ���� `� �� 1� Signature Witness Signature �l� - OLD METER# �.7 L� 1 7 3 7�Y OLD READING �� 3�U ��U NEW METER# ��I� �J��� NEW READING ERT# ��D� ��� I FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRA7'ION (Ref Ord fVo 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing or repair of any wates of sewer tine wnnecting the existing municipai system and any house or buiiding for which the application is made,the owner or co�rtractor shall be required to obtain a permit for such conr�ection,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 not�ed. It shail be unlawful to cover any connecting line until an inspedion has been made and such connedion and the work incident thereto has been approved by the City as a proper and suitabie connedion. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connecCion has been made to the water service wrb 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 appiicant,owner,or occupant or user of wch premises shall be liable for all repairs required to any water lirte and sewer lines necessary for connection of the premiscs from the main to the premises. If the property oarner requests maintenance service or repairs be performed bY the City,the property owner shall be charged for the costs of the maintenante and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applipnt� owner,occupant or user to perform standard maintenance of the sewer senrice line from the 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 remalns above the finished g�ade of the land or property. (Ref 638,1156,1191)