Meter Swap �..,
r Request Number: 12414 '�
Public Works Division
Service Request
Problem Address: 7424 Concerto Cur�e Requested By: Sam Kuhl
Departme�: WATER Addreas: No ad�ess provided
Problem/Iaa�: INSTALL AMR ME'IER P��Number: 763-656-7471
Se�edaled Date: 2016-12-12 Schednled Time: 10:00:00
��
ACIION NEEDED:AMR
Created by; Wend}+Hiatt Date Cre�ed: 2016-12-09
ACTION TAI�N:
_ �����'�-� j j� cl .� � rZ_
Statns: In Progress ��ner H�Beca �,
Contacted
Date Completed: Completed by:
� 2- ��- ��; G����.
City of Fridley
Water Department
6431 University.Avenue NE �3 � y�7�( ���3
" Fridley,MN 55432 j
• 763-572-3566 �b I �i � (
�/We ��`� hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. I 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 hoid the C'rty of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any wortc,if necessary.
FINAL METER READING(old meter) �l✓ � � ' � �
Name: �Gtii,V� ��.1�,�_ Address /���' l..i'�h G�i/' �G Ci�-�v C
Phone Number ��' 3 — �-" �� �7� ` I Date �� ~ l�� ��
� Signature Witness Signature �
OLD METER# I �� � {/` 1 ��
OLD READING �� � l 1 �a
NEW METER# �� i I ��Q q
NEW READING �
ERT# � � �� 1� 7 � '
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 ar�y house or building for which the
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter il of this Code. After wch connection has been made,the Water and Sewer Department shali be notified. It shall be unlavrful to�ver
any conneding line until an inspection has been made and such wnnection and the woric incident thereto has been approved 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 prope�ty line or a water service kad has
been extended to the property li�e for connection,the appiicaM,owner,or occuparit or user of such premises shall be liable for all rcpairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
�equests ma4r+tenance service o�repairs be performed by the City,the property owner shali be charged for the wsts of the maiMenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibility of the applicaM,
owner,occupant or user to perform standard mairrtenance 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 will ensure that it remair�s above the finished
grade of the land or property. (Ref 638,1156,1191)