Meter Swap . 1
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ctry of
Fridley
Request Numb�r: ���9�
Public Works Division
S�rvice R�qu�st
Problem Addreas: 71�0 Central Ave Reqn�Hy: Ron�ut�
Departmeat: WATER Address:
ProbkmJtssue: INSTALJ.AMR ME1BR Pf�one Nwnber: 631-331-3891 �� ,
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ACTION NEEDED: -
Crlat�d dy: Wendy Hiatt D�t� Cr'�at�d: 2017-12-06
ACTION TAKLN: ,��
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Statns: New Snbmttter Contacted: false
DAte Completed: Completed By:
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City of Fridley � �
Water Department �j� ��
6431 University Avenue NE
Fridley, MN 55432
763-572-3566
�/We hereby authorize the City of Fridley and/or 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 all iMerior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for a�ry damages that may occur while doir�this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand I am also required
to obtain a permit prior to any work,3f necessary.
FINAL METER READING(old meter) � 3�� � �a
Name: �r r/�� —I Address_ G � [ O L�(/��t �
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Phone Number � ���l' �� V' Date `� � � � � ° `
� Signature Witness Signature
OLD METER# �� � / �✓�� SIZE & STYIE(Cirdel
OLD READING � � � 5/ " HEX
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NEW METER# � {� 6 ` r � G L �,f`is' HEX
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NEW READING � 1�4" ELIPTICAL or HEX
ERT# ��"� l G �v � 2" ELIPTICAL or HEX
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FRIDLEY CITY CODE
CHAPTER 4d2.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
A02.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and ar�y house or building for whic�h the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shalf pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to cover
any connecting 11ne until an inspection has been made and such connection and the work incident thereto has been approved by the Ctty as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection 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 occupant or user of such premises shaU be IiaWe for aii repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be perfo�med by the City,the proqerty owner shal!be charged for the costs of the maintenancs and/or
repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. 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 including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiii ensure that it remains above the�nished
grade of the land or property. (Ref 638,1156,1191)
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