Meter Swap S
Request Number: 16168
Public works Division
Service Request
Problem Address: 541 Dover St Requested By: Susan Paiuter
Department: WA1ER Addreas: No a�ress provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-257-3611
Scheduled Date: 2017-07-11 ,__� Schednled 1lme: 09:00:00
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ACTIOl�i NEEDED:
Created by: Wex�dy Hi�,t Dnte Created: 2017-06-2?
``'x ' ACIION TAI�N:
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Status: 1n Pro�ess Submitter Has�een r,
Contacted
Date Completed: Completed by:
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' City of Fridley �
%� -� So�(o��-pl
Water Department
6431 University Avenue NE S� j� �O
Fridley,MN 55432 � �
763-572-3566
I/we hereby authorize the City of Fridiey and/or its employees to do what is�ecessary to
reptace the water meter. t understand that the property owner is liable for the water line from the main to the premise and alt iM:erior
plumbing. (Per City code 402.06j I also hold the City of Fridley and/its employees harmless for arry damages that may occur while doing this
operation. This to intlude,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 work,if necessary.
FINAL METER READIAIG{old meterj v � ����
Name•�11� �Gh�� Address �� �`�' _
Phone Number �"�� p� � � � r `�
�Si�re Witness Signature
OLD METER#_ {��-I ����
OLD READING _ �� � (p�Q
NEW METER# .�������CJ
NEW READING l /
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEIAIER
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 fo�which the
application is made,the owner or corrtractor shali be required to obtain a permit for wch connedion,and shalf pay a permit fee as provided i�
Chapter 11 of this Cade. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shail be unlawful to cover
any conneding line until an inspection has been made and such connection and the work incident thereto has been approved by the C�ty 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 iine or a water service lead has
been extended to the property line for connection,the applicarrt,owner,or occuparit or user of such premises shall be iiable for ail repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. tF the properly ow�er
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annually by an admi�istrative poliry. It shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris cl�aring or
root cutting and#o maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)