Meter Swap Request Number: 13003
Public Works Division
Service Request
Problem Address: 7560 Brigadoon Pl Requested By: Gary Brisbin
Deps�rtme�: WATER Addreas: No address provi�ed
ProMemllss�: INSTAI.L AMR METER Phone Number: 612-624-7979
Schedul t: 201?-01-2 � Schedaled'tlme: 11:OO:OiI
ACIION NEEDED:
Created by: Wer�y Hiatt Datt C�eated: 2017-0 i-23
ACIION TAKEN:
iw ��� 1�9£-� :1�� �
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Status: In Progress �be�itter H�Been �..
Custacted
Date Comptet�d: � _ � R ,� �� Completed by:
V ���$
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Water�e�arta�nerat �
6431 iJniversity Avereue 6VE �C� �(.�,� �,.
Fridley, MN 55432 �C� � ,� �� � C
A 753-572-3566 S � �� I �
9/we her�by authorize the City af Fridley and/or its empioyees to do what ds necessary to
replace the water metec. 1 understand that the propea�tty owner as liabte for the water line from the main to the premise and ail i►rterior
plumbing. {Per City code 4Q2.06) i afso hoid the City af Fridley and/its employees harmless#or eny slamages that may occur whife doing this
operation. This#o�nclude,but not limi#ed to valves,piping,waUs,floors or the curb stop box and service line. In understand!am also require�
to obtain a permit prior to any+�vor6c,if necessary.
FINAL METER READING(old meter} �J 1 8 � (/D
Name: �G`'(�`� in��J rJ'' ` Address � � '�� .
Phane Num �Z � �2 1" l� l� pafie l�' � ~� !
4
Signature W'rtness Signature �'
OLD METER# _�v� �� ��,
OLD READ[NG � (, v � �
�� n�
`�N v
NEW METER#_ l S � v �� O �
r''Yv�
NEW READttVG �
E�# � 1 � � a5a � .
FRIDI.EY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMIf111STit�4Tf0'N
(Ref Ord No 113,4b4,565,566,629,638,662,922,988,1144,I156,S191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry fiouse or bu�iding for which the
appi3cafiion is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided irr
Chapter 11 of this Code. After such conaection has been rnade,the Water and Sewer Departmern shaQ be notified, tt shail be unlawful to caver
any connecting tine until an inspecCion has been made and such connection and the wro�inciderrt thereto has been approved by the Crly as a
proper and suitable connection.
40Z.06 REPAIRS AND MAIPITENANCE TO CONNEC770N
After the initial connection has been made to the water service curb sto�box or the sewer lead at fihe property iine or a water service Iead has
been extended to the property line for connection,the appi'�casrt,owner,or accuparrt or user af such premises shali be liabie for all repairs
required to any water line and sewer iines necessary for connection of the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be perFormed by the C'ity,the proper+ty owner shall be charged for the costs af the mairrtenance and/or
repairs,including necessary sereet repairs at a rate set annualfy by an administrative poliry. It shall be the responsibillty of the applicarit,
owner,occupar�t or user to perform standard maintenance of#he sewer service line from the premises Co the main includir�g de6ris dearing or
ro+ot cutting and to ma�rrtain the water service curb sfiop box for operability and at such height as wili ensure that it remains afiove the flnished
grade of the land or property, (Ref 638,1156,1191j