Meter Swap Request Number: 12869
Public works Division
Service Request
ProWem Address: 7486 Bacon Dr Reqe�ested By: Jeromy�oga
DepartmeM: WATER Addres:: No address provided
Probem/7ssue: INSTALL AMR METER Pho�e Nymber: 763-?83-2176
Sehedaled Drte: 2017•01-19 Sc6edoled'i1me: 08:30:M1
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AC>'IION NEEDED:
Created by: Wendy Hiatt D�e Cre�ted: 2017-01-13
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� . ACTION TAI�N:
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Stat�: In Progcess 3ebmitter Ha B�e �
Coetacted
Date Completed: �—l �-- �� Completed by: ��`,�
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L9L,(�T 1'I'IQIC'y
Water�epartment �a�� ��� g�'� ,� � �
6431 University Avenue NE
Fridley,MN 55432
763-572-3566 � (-� � �; i _�'
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�rWe hereby authorize the City of Fridley andjor its empioyees to do what is necessary to
replace the wafier meter. 1 understand that the property owner is liabte for the water line from the main to the premise and all interior
plumbing. {Per City code 402.06) i atso hold the C'rty of Fridiey and/its employees harmless for any slamages that may occur while dang this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand l am aiso required
to obtain a permit prior to any�►rork,if necessary.
FttVAI METER READING(o{d meter) �i��-" � 6 l ��
Name:� �- 1"'CT�-'�/ �1�' C�9�'/�. Address t�' lJ�.� �e�� �3^,
Phone Numbe� L �� � ��-'f�2-� (l�v p� t'— '-1 ���
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� Signature Witness Signature
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OLD METER#_ L� � � w � `
OLD READiNG ��� �C�
NEW METER# `� �� � �� �
IVEW READING �
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANI'fARY SEWER
ADMlNlSTRATION
(Ref Ord Alo 113,464,565,566,629,638,662,922,9$8,1144,1156,1191)
402.5 PERMIT FEE
Prior to�onstructing or repair of any water of sewer line connecting the existing municipai system and any fiouse or buildir�fo�which the
application is made,the owner or contractor shall be requi�ed to obtain a permit for such connection,and shall pay a permit fee as previded in
Chapter 11 of this Code. A'Fter such connection has been made,the Water and Sewer Departmerrt shall be notified. It shaii be uniawful to c�rer
any connecting line until an inspectiort has been made and such connedion and the woric inciderrt thereto has been approved by the Cdy as a
proper and suitabte wnnection.
402.Q6 REPAlRS AND MAfNTE111RNCE TO CONNECiION
After the inrtiat coanection has been made to the water servtce curb stop box or the sewer lead at the pmpe�li�e or a water�rvice�ad has
been extended to the properly line for wnnection,the applicant,ownes,or occupaM or user af such premises shal!be P�able for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property ovimer
requests maintenance service or repairs be performed by the C'rty,the property owner shaN be tharged for tfie costs af the mairrtenance and/or
repairs,including necessary street repairs at a rate set annualfy by an administrative policy. It shall be the responsibility of the appliprrt,
owner,occupar►t or user to perform standard maiMenance of the sewer senrice line from the premises ta the main indudirig debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade Qf#he land or property. (Ref 638,1156,1191)