Meter Swap Request Number: 15799
Public Works Division
Setvice Request
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— '---r��__ __ress: 531 Dover St Requested By: Brian
Department: WA1ER Addreas: No address provided
Problem/Issue: INSTALL AMR METER Phone Nnmber: 651-245-5739
Scheduled Date: 2017-06-23 Schedaled 1lme: 10:00:00
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ACfION NEEDED:
Crextcd by: Beth Ko�ick Date Crerted: 2017-06-06
ACIION TAI�N:
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Staters: In Progress Submitter Has Been r,
CoMacted
Da�te Compieted: Completed by:
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�C;�o��rsaley ��y�y�� �'`" � �
, Wat�r Departeraere� ��� ����
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6431�niversity Avenue NE
Frodley,MIV 55432
763-572-3566
�,°"�e hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace#he water meter. i understand that the property owner is fiabfe for the oarater line from the enain to the premise and ali interior
plurnbing. (Per City code 402.06) 0 also hold the Citgt of Fridley and/its emptoyees haemtess for any damages tfiat may occur white doing this
operation. This to indude,but not limited to valves,pipin{;,walts,floors or the curh stop box and service line. in understand I am atsfl requin
to obtain e permit prior to any work,if necessary.
F9AIAL METER READ1lVG(o1d m�te�) ����� �O
Piame• ���I l. Address _ �� ` �
Phone�lumber���� '�w I�� p� � '—��j" ��
`Si nature Witness Signature
OLD METER# _ b�������
OLD READtNG��� � 2--��
NEW METER# ���i��J
NEW READtNG �
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FRIDLEY CITY CODE
C�fiAPTER 4U2.WATER,STf�RM WATER AND SANiTARY SEWER
ADMINfSTRAl'ION �
(Fief Ord No 113,464,565,566,629,638,662,922,988,1.144,1156,1191)
402.5 PERMIT FEE
Prior to constructin�or repair af any water of sewer line connecting the existing municipal system and any house or buiWing for vvfiich the
appiication is made,the owner or wntractor shali be required to a6tain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shalt be notified. it shall be unlawful to cover
any connecting line urrti!an inspection has beeo made and such connection and the work incident thereto has been approved 6y the C'rty as a
proper and suitable connection.
402.06 REPAIRS ANQ MAIM'ENANCE TO COPlNECTION
After the initiat cannection has been rnade to the water service curb stop box or the sewer lead at the property line or a water senrice lead has
been extended to the property line for sonnection,the applicarrt,owner,or occvpar�t ar user af such premFses shall be tiabfe for aN repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shatt be charged for the costs of tlse mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an admirtistrative policy. !t shall be the responsibifity of the applicar�t,
owner,occupant or user to perForm standard maintenance of the sewer senrice line from the premises to the main inciuding debris dearing or
root cutting and to maintain the rovater service curb stop box for operability and at such height as wiii ensure that it remains above the finished
grade af the tand or property. (Ref 638,1156,1191J