Meter Swap �
� , � � Request Number: 12406
�'�'� Public Works Division
Service Request
Probtem Addreas: 7449 Able St Requested By: Rob Olson
Department: WATER Address: No address p�ovided
Problem/Issue: IN5TAL.L AMR METER Phone Number: 651-600-6511
Schedul te: 2016-12-14 Schedaled'Ilme: 08:30:QU
�
�ox xEEnEn: �� S C. l 3
Created by: Wendy Hiatt Ih�te Created: 2016-12-09
ACTION TAI�N:
Status: In Progress Sub�uitter Aas Been r,
Cont�cted
Date Compieted: Completed by:
City of Fridley
Water Department
. 6431 University Avenue NE
` ` Fridley,MN 55432
• 763-572-3566
1/we hereby autfiorize the City of Fridley andjor its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and a{I irrterior
piumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmfess for any damages that may occur while doing this
operation. This to include,but not limited to vaives,piping,wal{s,floors or the curb stop box and service line. In understand 1 am atso required
to obtain a permit prior to any work,if necessary.
F14VAL METER READIM6(old meter)
Name• A�ddress
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
ADMIN{STRATION
�Ref Ord No 113,464,565,566,6Z9,638,662,922,988,1144,1156,1191)
4fl2.5 PERMIT FEE
Prior to constructing or repair of any water of sEwer line connecting the existing municipal system and ar+y house or buiiding for which the
appfication is made,the owner or contractor shal{be required to obtain a permit for such connecNor+,and shali pay a permit fee as provided in
Chapter 11 of this Code. After such connection fias been made,the Water and Sewer Departmesit shaN be notified. ft sfiafl be uniarrful to cove�
any connecting fine until an i�spection has been made and wch connettion and the woc�c incident thereto has been approved by the City as a
proper and suitable connectio�.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial coneection has been made to tfie water service curb stop box or Che sewer lead at the property line or a water service lead has
been extended to the property line for connection,tfie appiicartt,owner,o�occuparrt oc user of such premises shaN be fiable for all repairs
required to any water line and sewer lines necessary for connection of the premtses from the main to the premises. ff the property owner
requests maintenance senrice or repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance aed/or
repairs,inciuding�ecessary street repairs at a rate set annualiy by an administrative paliry. It sfialf be the responsibitiiy of the appllarrt,
owner,occupa�t or user to perform standard maintenance of the sewer service line from tfie premises to the main inciu�rig debris dearing or
root cutting and to maintain the water service curb stop box for opeeability and at such height as wiil ensure that tt remains above the ftnished
grade of the land or property. (Ref 638,1156,1191)
City of Fridley ��
Water Department �L..�l �y �' 3
, • 6431 University.Avenue NE
� Fridley,MN 55432 �v ) -t� �j�-c,�����
, 763-572-3566
(�., �
�IWe ,"� �E� hereby authorize the City of Fridley andior its emptoyees 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 ali iMerior
plumbing. (Per City code 402.06) f also hold the City of Fridtey and/its employees harmless for arry damages thai may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understa�d 1 am also required
to obtain a permit prior to any work,if necessary.
FiNAL METER READING(ofd meter) t✓
� �S� �
Name: , Address �� �r`��l �i'�� � ��� `�
phone Number �n� 1 � l� O��- "� � ) Date f �^' ��"' 1 �
5ignature___� � � Witness 5ignature �
OLD METER# �L�� � J � O
OLD READING (1�2�13(�
R
' NEW METER# ` 1 �� � ��I
NEW READING �
ERT# � �� � � 1 �� � �
, ��,.
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,565,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to sonstructing or repair of ar�y water of sewer line cflnnecting the existing municipai system and amt house or building for which the
applicatioo is made,the owner or contractor shall 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,tfie 1Nater and Sewer Department_shall be notified. ft sha{{be unfawfui to cover
any connecting line until an inspection has been made and suth connection and the work i�cident thes�eto fias been appranred by the City as a
proper and suitable connection,
402.06 REPAIRS AND MAINTENANCE TO CONAIECTION
After the(nitial connection has been made to the water service curb stop box or the sewer fead at the property line or a water service lead has
beea extended to the property line for tonnection,the applicant,owner,or occupaM or user of such premises shail be liabie for aN repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the properly owner
requests mairrtenance service or repairs be perFormed by the City,the pro�rty owner shaii be charged for the costs of the maintenance andjor
repairs,including necessary street repairs at a rate set annually by an administrative pofiry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main iedud+ng debris dearing or
root cutting and to maintain the water service curb stop box for operabifityr and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
�
,.. ; �� '
, �j ����� �
, �I�-
Ci y of�dley
,{ Water Department
.. Address 1 7 � /--c� �� ' _
,,_. �
�
, , ___
.. . Name u..a�.��- (y
' Date ` �'�- CC�
' Old Meter Number 9 � �
Old Meter Reading -�
-
' Replacement No. .3 �"7 �/.� � � ; _
" Replacement Reading C�
� Replacement Make �S�.,��_ -
.,, ' Remarks: o�� �,.�%c�.- �
��,�
Signed � _
, -
;
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