Meter Swap � Request Number: 16119
� Public Works Division
Serv�ce Request
Problem Address: 7995 Broad A�ne Requested By: Mark Wilson
Department: WA1ER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Numlxr: 952-457-9446
- Scheduled Dxte: 2017-07-10 � Scdeduled 13me: 02:00:00
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ACTION NEEDED-
Created by: Wendy Hiatt Date Created: 2017-06-23
ACTION TAI�N:
_.__....�......_..._._....�.-'-�5'�-�,t�._�.........................�....�''�.:....'..�:.`�....-�........__.� __ ___
Status: In Progress 5abmitter Has Been r.
Contacted
Date Completed: '�s �� �� Completed by: � �
� a c�
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City of Eridley
' Water Department �jy� -0
� 6431 University Avenue NE � c�e� ' ✓"- � �
Fridtey,MN 55432 ���- jl/,���
�.���
763-572-3566
t/we hereby authorize the Crty of Frid(ey and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the watec line from the main to the premise and all interior
plumbing. (Per C'rty 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�ot limited to valves,piping,waffs,floors or the wrb stop box and service line. in understand I am aiso required
to obtain a permit prior to any work,if necessary.
FINAL METER READtNG(old meter} � V V" � �� `�
Name: '_`"'��1'� �� 1��� Address b � i,✓ � �
Phone Numbe �✓�" ' �' �����te V`'�•�`J� /
�Signatur Witness Signature �r
OLD METER# � ��� 6�� /
OLD READING " � � / �� �
NEW METER# L v�✓ `"-" `-��
NEW READlNG "
E�# ��� a3�� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND 5ANITARY SEWER
ADMINISTRAT{ON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,2191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line co�necting the existing municipal system and a�y houss or buiiding for which the
application is made,the owner or contrador shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawfui to cover
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 suitable connection.
402.06 REPAIRS ANO MAINTEfYANCE TO CONNECTION
After the initial conn�ction has been made to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for connection,the applicant,owner,or occuparit or user of such premises shaii be liatile for all repairs
required to any water line and sewer lines necessary for coenection of the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the matr�tenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. lt sha!!be the�esponsibi{ity of the applicarrt,
owner,occupant or user to perform standard maintenance af the sewer seroice line from the premises to the main including debris clearing or
root cutting and ta maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
. . .�. , . � �� �ur...wn..ir� ..
� � % (j 3-��
1 a���s -5cx�a �J
City of Fridley
Water Department
Address ��y,J �� 0'a.� /�'��
Name , .
Date — � � � l v
Old Meter Number ��� 7� 2 O 1
Old Meter Reading 7 7 Q a v
Replacement No. � S d �� f
Replacement Reading �
Replacement Make f.��-�- -e�
� Remarks• `
Signed
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