Meter Swap ,
� Request Number: 15865
Public Works Division
Service Request
Probiem Address: 540 E1y St Requested By: Pam Zieglan
Department: WATER Address: No address�ovided
Probiem/Issue: INSTAI,L AMR METER P6one Number: 763-786-6394
5chednled Date: 2017-06-12 Schednled 1lme: 01:00:00
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ACTION NEEDED:
Cre�ted by: Beth Kondrick Date Created: 2017-06-07
ACIION TAKEN:
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Status: In Progress Sabmitter Has Been r,
Cout�ted
Date Compieted: �.- �a� �� Completed by: �a (�, �
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�Jiy o#Fr6d�e71 :./r/� ' � / "��L/ "rVl
, Water De�rtmert� �� � ��
6431 lJni�ersi Avenue NE ��
~ Fsrodiey,MN 55432
763-572-3566
�0'"�e hereby authorize the Crty of Frid(ey and/or its empfoyees to do what is�ecessary to
replace Lhe water meter. 1 understand that the property owner is liabte for the water line from the main to the premise and all irrterior
plumbing. (Per�ity code�02A6) I also bold the Citgt of Fridley andrts employees harmless for arry damages thafi may occur while doing this
operation. This to include,l�ut not limited ta aalves,pipin&walis,#Ioors or the curb stop box end service line. !n ondentand!am also reyuirE
to abtain e permit prior to any worlc,if necessary.
FtNAt METER READiNG(oid meter� ���� ��/
Name• " "v� �^ti� b��L Address_ � ��� � ,S�
Phone 9Yumber [��� ���-t��� p� � -- �v �
Signatur ' Witness Signature
OLD MtTER# ��d � ` /
OLD REAOtNG _ G�✓V� V ��
NEWMETER#_ �� ��111 �� C�
RIEW READtNG �
ERT# �� �p�. �� p�.�
FRIDLEY CDTY CODE
CHQPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATlON �
�Ref Ord No 113,Q�4,565,566,629,638,662,9Z2,958,1144,1156,i191)
402.5 PERMIT FEE
Prior to constructin�or repair of any water of sewer line connecting the existing municipa!system and arn/house or buHding for which the
application is made,the owner or contractor shaN be requirec!to obtain a permit for such conr►ection,and shali pay a permit fee as provided in
Chapter II of this Code. After such connedion has been made,the Water and Sewer Departmerrt shali be notfied. It shatl be untawfut to cover
any connecting line until an inspection has been made and such connection and the work 9ncident thereto has been approved by the City as a
groper end suitable connection.
402.06 REPl�IRS ARID MAINTEPIANCE TO CONNECTIORI
After the inifiiat connection has been made to the water seroice curb stop box or the sewer lead at the property line or a water service tead has
bee»extended to the property line for connection,the applicarrt,owner,or occuparrt or user of such premises shall be liable for a!1 r�epairs
required to any water dine and sewer(ines necessary for connection af the premises from the main to the premises. tf the property owner
requests maintenance service or repairs be performed by the�ty,fihe property owner shall be char�ed for the costs of the maintenance and/or
repairs,iacluding necessary street repairs at a rate set annually by an administrative poliry. !t shaA be the responsibiliiy oF the applicant,
owner,occupant or user to perform standard mairitenance of the sewer service dine from the premises to the main irtcludirig debris clearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as witl ensure that it remains above the finished
grade af the(and or property. (Ref 638,1156,1191j
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