Meter Swap � Request Number: 16110
Public works Division
Service Request
Problem Address: 687 Do�r St Requested By: Judy
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-784-0168
Scheduled Date: 2017-06-2 Scheduled 13me: 10:30:00
rY1� (.(. �'` (�'
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-06-22
ACTTON TAI�N:
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Statns: in Progress Submitter Has Been r
Contacted
Date Completed. Completed by:
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. City of Fridley Sa# �g l 7
Water Departrnent
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
��`"�e hereby authorize the City of Pridiey and/or its employees 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 interior
plumbing. (Per City code 402.06) I also hold the City of Fridiey and/its empioyees harmless for any damages that may occur while doing this
operation. This to include,but not limited to vaives,piping,walis,floors or the curb stop box and senrice line. In understar�d i am also required
to obtain a permit prior to arry wortc,if necessary.
FINAL METER READING(old meter) �"`�'" � � I � �
Name:�, _ Address �t✓ � ( �✓ Q U'� �.
Phone Number �/� � 6 � 1,''�� �C�ate __ � � �� — l,� �
�-Signature Witness Signature "��
OLD METER# � ��D�V ��
OLD READING �� � yv�
NEW METER# � 1 d���p3��
NEW READING �J ,�:
ERT# � a�� �.� � a 3
FRIDLEY 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 any fiouse or building forwhich the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initiai connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user oF wch premises shall be liable for ail 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 performed by the City,the properly owner shaii be charged for the costs of the mair�tenance and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative policy. It shail be the responsibility of the applipnt,
owner,occupant or user to perform standard mair�tenance of the sewer senrice 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 remains above the finished
grade of the land or property. (Ref 638,1156,1191)