Meter Swap s
Request Number: 15236
Public Works Division
Service Request
Problem Address: 721?East River Rd Requested By: Patrick
Department: WA1ER Address: No a�ress p�ovided
Problemllssue: INSTALL AMR METER Pbone Number: 651-233-9243
Schednie te: 2017-OS-10 � Se6edaled Tlme: 10:30:00
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ACTION NEEDED:
Created by: Wex�y Hiatt Date Crested: 201?-OS-09
ACIION TAI�N: r
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Status: In Progress 5abmitter Has Been �..
Contacted �
llnte Completed: �^ �'^ � Completed by: C �+ �
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City of Fridley � � � �I v� �
Water Department
6431 Universifiy Avenue NE
Fridley,MN 55432
763-572-3566
UWe hereby autho�lze the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property awner is liabie for the water line from the main to the premise and all interior
piumbing. (Per�ty code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,l�ut not limited to valves,piping,walls,floors or tfie curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter)__ � V l� � l,/ l v
Name• �a��� G�� Address �� ` ► �`7� �'�V` i�.
Phone Number_�1G"J 6✓ �-J3� �� Date � ~� � ��
»
Signature Witness Signature
OLD METER# �� � (
OLD READING � v l�
NEW METER# � �U� ��� S
NEW READING v
ERT# � ( I� ��� 1
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
A�MINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMI7 FEE
Prior to constructing or repair of arry water of sewer line wnnecCing the existing municipai system and arry house or buifding for which the
application is made,the owner or contrador shall be required to obtain a permit for such connectio�,and shali pay a permit fee as provided i�
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shell be notified. tt shall be unlawful to cover
any connecti�g line u�til an inspedion has been made and such connection and the work incldent thereto has been approved hy the City as a
proper and suitabie co�nection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initia!cos►nectio�has been made to the water service curb stop box or the sewer lead at the property Itne or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shali be liable for all 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 property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annualiy by an administrative 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 dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that ft remains above the finished
grade of the land or property. (Ref 638,1156,1191)
o� .�-.5� i � �,��- ����
� � INSTALLATION
' {
anroF STANDARD WATER METER �
FRIDLEY
Address �� � ����' U��
Name
�ate�I —1�` �Z�
Old Meter Number � � �-� � , I�
_� `
Old Meter Reading ��S� � J �'
Replacement Na � � � � � � �
Replacement Reading �
Replacement Make �SCic�-�.2�
Remarks: ��C7is� �C'���'�
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Signed: