Meter Swap Request Number: 15123
` Pubhc Works Divicion
Service Req�st
' Problem Address: 7234 East River Rd Requested By: David
Depu�tment: WA'IER Address: No ad�ess provi�d
ProblemlIssue: INSTALL AMR METER Phone Number: 763-571-0554
Sededuled Dste: 2U17-OS-04 ��edaled'Iime: 10:30:00
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ACZiON NEEDED:
,,Created by: Beth Kondrick Date Created: Z017-OS-03 �
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ACIION TAKEN:
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Status: In Progress S�bmitter Has Been r
Cout�ted
Date Compieted: � _ u� l� Completed by: ����
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• City of Fridley �-� 3 '�
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Water Department � � /
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/We hereby authorize the C'�t�r of Fridley andjor its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and afl interior
plumbing. (Per City code 402.06) t also hold the City of Fridley and/its employees harmless for any damages that may octur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING old meter " ��v � �O
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Name: l✓�� Address �� ��7`J' 1�-1`� � •
Phone Number `� t/v � `'f� v� ate � � `� � ��
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Signature Witness Signature
OLD METER# �
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OLD READING �� V ��,O
NEW METER# `�� " ���
NEW READING �
ERT# ��o����CJ�
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 house or building for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provtded in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department sMali be not�ed. It shall be unlawful to wuer
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City es a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the i�itial connection has been made to the water service wrb stop box or the sewer lead at the property ifne or a water seMce 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 tor connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by tfie City,the property owner shail be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administsative policy. It shail be the responsibility o�f the appiicant,
owner,occupant or user to perform standard maintenance 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 hetght as wlll ensure that tt remains above the finished
grade of the land or properly. (Ref 638,1156,1191)