Meter Swap Request Number: 12379
Pubhc Works Division
Service Request
Problem Address: 7331 Co�erto Curve Requested By: Robert Nielsen
Departme�: WATER ,�.e3S: 7331 Concerto C�
Fridley,MN 55432
Problem/7ssue: INSTALL AMR ME'IER Phone Nnmber: '763-548-4097
Schednled Da� 2016 -16 Schedeled Zime: 01:00:00
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ACTION NEEDED:Install AMR
Created by: Beth Kandrick Ds�te Crested: 2016-12-07
AClION T
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Status: In Progress ��ner H�Bcen r,
Coats�ted .
Date Completeds Completed try:
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City of Fridley � ``1 � �� I �
Water Department
` 6431 UniversityAvenue NE ��,��--l�t���
Fridley,MN 55432 `�v�
763-572-3566
1/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) 1 also hold the C'ity of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to inciude,but not limited to vaives,piping,walis,floors or the curb stop boz and service lioe. In understand t am atso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter� ��3� ���
Name: �{��� � (�Jl�h Address ` ��� �Y���� l.J�YV�_-_
, � 1
Phone Number � `�~� � {� Date `�— i '�✓ �
�Signature j Witness Signature
OLD METER#�S��O�-`
OLD READtNG_��� � �
NEW METER# � 1 1 � �
NEW READING 1 1
—�
ERT# �'Z, 1J� V���,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINtSTRATION
(Ref Ord No 113,464,565,566,629,638,662,92Z,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line�nnecting the existing municipal system and arry house or buildir�for which the
application is made,the owner or cor�tractor shall be regui�ed to obtain a permit for such connection,and shall pay a permft fee as provided in
Chapter 11 of this Cade. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shall be unlawful to crnrer
any connect'sng line until an inspection has been made and such connection and the worlc incident thereto has been approwed by the City as a
proper and suitable connection.
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 tead has
been extended Lo the property line for connection,the applicant,owner,or occupar�t or user of such premises shal{be liabie for all repairs
required to any water line and sewer lines necessary for connect+on of the premises from the main to the premises. if the p�operty owner
requests mairrtenance service cr repairs be performed by tl�e City,the property owner shali be cha�ed for the costs of the maintenance and/or
repairs�incfuding necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibii'rty of the applicarrt,
owner,occupant or user to perform standard mair�tenance of ihe sewer service line from the premises to the main indudirig debrls dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiii ensure that it remairu above the finished
grade of tfie fand or property. (Ref 638,1156,1191)
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City of Fridley �
Water De»artment
Address _����G,c-`i.a('.�-2�0 �Q�
Name �,,C��,'fLT �/��-L.� 1
Date �1�i�0�
Old Meter Number q` ' �°I o�
Old Meter Reading
Replacement No. 4 �,a����
Replacement Reading �
Replacement Make ��(at3fl.
Remarks: �"C�ppt� /��'�'�.,
, Signed