Meter Swap #�.
` _ Request Number: 12902
Pubtic Works Division
Service Request
Problem Address: 7613 Central Ave Requested By: Robin llwyer
Department: WA'IER Address; No adc�ess provided
Problem/Issue: INSTALL AMR METER Phoee Number: 763-447-8376
Schednied 2017-01-18 Schedeled 1lme: 07:30:00
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AC"IION NEEDED:
Created hy; WendyHiatt Date Created: 2017-01-17
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Status: In Progr�ss Snbmitter Ha�Beea �,
Co�acted
Date Compteted: Completed by:
c� � � �— ►�� � �
�o�/or rr�aoey ��
Water Departs�nent � � G ��
6431 llniuersity Avenue PIE �
�' ' Fridley, MN 55432 �vt,��vy�c����
� 763-572-3566
!/we hereby authorize the Ciiy of Pridley and/or its empioyees to do what is necessary to
replace the water meter. !understand that#he property owner u liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) i also hold the C"tty of Pridiey andrts employees harmless for anq damages that may occur while doing this
operation. This to inciude,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand!am also required
to obtain a permit prior to any wor6c,if necessary.
FIAIAL METER READING{ald meter] � �� ����
Name: ` � � r ` �`� �,� Address �b I � w�� �v'�
Phone Number_pacJ� � � ��v� � p� I — �� �
�Si nature �
� Witness Signature
OtD METER# ��U ' 3 �'I 7�
OLD READtNG �� ��
NEW METER# ( � I' � ��� �
NEW READING �
ERT# � � �Xl� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEYYER
ADMINISTRATION
(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 municipai system and arry house or building for whkh the
apptication is made,the owner or contractor shafl be required to obtain a permit for such connection,and sFiali pay a permit fee as provided in�
Chapter 11 of this Code. After such connection has beea made,the Water and Sewer Department s(�ali be notffiect. it sha11 be unlawfut to cover
any connecting line untii an inspectio�has been made and such connection and the work inaderrt thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AMD MAINTENMICE TO CONNECTIUN
After the initiai connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water seroice tead has
been extended to the property line for connection,the appiicarrt,owner,or acwpant or user of such premises shall be liable for ell repairs
required to any water line and sewer lines necessary far connection of the premises from the main to the premises. tf the property owner
requests mairitenance service or repairs be performed by the Clty,the property owner shail be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrafive policy, tt shatl be the responstbility af the applicarrt,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the mai�including deb�is clearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as wiil ensure#hat it remains above the finished
grade of#he land or property. (Ref 638,1156,1191)
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3 tiY � tCaa
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. City cf Fridley
water Department
Address � ,,�� ���'�'� ��{��-
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Name 1 � � �,r +�l'
Date � ." � �'"* �
Old Meter Number � �����
Old Meter Read��g � � �` � �� `
Replacement No.
Replacement Reading �
Reglacemerit Make �Q� �£�
Remarks; /�;ts�,�A�'
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