Meter Swap REQUEST FOR SERVICE REPORT
CITY OF FRIDLEY
Reference No. '"'7 / _ �� Date: �_a—�,�
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Request Type: Entered By:
Department: � Citizen Name:
Address: �� �� Phone Number:
Scheduted Date: Property Owner:
Location Details: Request Details:
Action Taken:
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Responsible Person:
Approver:
� Compietion Date: � Citizen Noti€ied:
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City of Fridley J" �" �(�'�`
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all ir�terior
plumbing. (Per City 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,but not limited to valves,piping,walls,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 READING(old meter) � � � ay B ���
Name• Addrcss � GC..�1
Phone Number Date 1�
Signature � Witness Signature
�LD � � •
���t�� �� SIZE & STYLE(Circle)
OLD READING � -6 _b � 5/8" HEX
L-(�s �6`7C� ��s
NEW METER# 1" HEX
5AN►� Bovy �
�� �.
NEW READING 1�4" ELIPTICAL o� HEX
�� ERT# ���� v`� � � 2" ELIPTICAL or HEX
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 whkh the
application is made,the owner or contractor shall be required to obtain a permit for such connedion,and shall pay a pennit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Departme�shall be notifted. 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 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 line or a water servic�e lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for ali 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 shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responstbility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
� Request Number: 16253
}.
Public Works Division
Service Request
Probiem Address: 680 Ely St Requested By: Jolm Cutzer
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-784-744�
°I S�.k.-I-c�c�.s�� �pl�c� ua�i,,<s ,
Schedul ed Date: 2017-07-10 SchedW ed'I3 me: 08:30:00
n� :3c�
ACTION NEEDED:Turn off water so val�e can be replaced Install AMR
Created by: Wendy Hiatt Date Created: 2017-07-06
ACTION TAI�N:
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Status: In Progress Submitter Has Beee r ,
Co�acted
Date Completed: Compl ted by:
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, City of Fridley 7�� '����/
.� Water Department � � , ,h�O
6431 University Avenue NE �-f��
Fridley,MN 55432
763-572-3566
��We hereby authorize the City of Fridiey and/or its employees to do what is necessary to
replace the water meter. i understand that the property owner is tiable for the water line from the main to the premise and all interior
piumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for arry damages that may occur white doing this
operation. Tl�i�to indude,but not limited to valves,piping,waffs,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any wor{c,if necessary.
FINAL METER READING(old meter) `� �� _' ��
Name: Address �_(�..J ��
Phone Number Date �(�"
Signature O� �- `� Witness5ignature
OLQ METER# ���� o �a
OLD READING ���h,J� � �J
. � : . � �l� �� 6�p
NEW METER#
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NEW READING � � � '
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FRIDLEY CiTY CODE ''' `�"'^
:y�,
CHAPTER 402.WATER,STORM WATER AND SANITARY 5EWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to construding or repair+of any water of sewer line conneding the existir�g municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has heen made,the Water and Sewer DepartmeM shafi be not�ed. It shall be unlawful to cover
any connecting line until an inspection has been made and such wnnection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTIQN
After the initial connection has been made to the water service curb stop box or the sewer fead at the property tine or a water senrice lead has
been extended to the property line for connectio�,the applicant,owner,or occupant or user of such premises shail be liable for all repairs
requtred to any water line and sewer lines necessary for cortnection af the prernises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the pcoperty owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative palicy. it shall be the responsibifity of the applicant,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water senrice curb stop box for operability and at such fieight as wii{ensure that�t remains above the finished
grade of the land or property. (Ref 638,1156,1191j