Meter Swap �.
' Request Number: 12380
Public Works Division
Service Request �
Problem Address: '7360 Concerto C�r� Requested By: Patrice.An�derson
Department: WA'IER Addreas: No address provided
Problem/Lssue: INSTALL AMR METER P�ne Nnmber: 763-639-0886
ScLeduled 016-12-08 Schednled'I1me: 11:30:00
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ACIION NEEDED:AMR
Created by; Wendy Hiatt Date Cre�ed: 2016-12-07
ACIION TAI�N:
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Status: In Progress Sabmitter HAs Beea �
CoMaeted �
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D�e Completed: Completcd J 1
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City of Fridiey I �
Water Department �� � �
6431 University Avenue NE
�ridtey,MN 55432 ��r,^ �y�yO��
763-572-3566 ��
I/we_ ���-��'C hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. !understand that the property owner is liable for the water line from the main to the premise and all interior
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 valves,piping,waiis,floors or the curb stop box and service line. In understand t am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter)
9 �W � � �a
Name:�G.�r(`L`CY ��1("',�Ut^ Address 7 7�OC1 �A►�C'Q,J`'�v �1.�.✓`'�'�.
Phone N ber �� — lv� ^ v(7�Y! uate_�,/Z." C7` `�
Signat e �- 1 Witness Signature �a ��
OLD METER#_ ~� � � � � / �/ �
OLD READING ��—t � ��v
NEW METER# � 1 �i � J � I
NEW READING �
ERT# v � � � 4 `� ��
FRIDIEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
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 municipal system and arry house or building for which 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 12 of this Code. After such connection has been made,the Water and Sewer Departmerit shall be notified. it shall be unlawful to cover
any connecting line untii an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connectFon has been made to the water service curb stop box or the sewer lead at the property 1lne or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the properly owner
requests mairrtenance service or repairs be performec!by the City,the property owner shall be charged for ihe costs of the mairnenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. it shali 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 dearing or
root cutting and to maintaM the water service curb stop trox for operability and at such height as wil!ensure that it remains above the fiinished
grade of the land or property. (Ref 638,1156,1191)