Meter Swap .
Request Number: 15863
Public works Division
Service Request
Problem Address: 684 Ely St Requested By: Don Ryder
Department: WATER Address: No address provided
Problem/L�sue: INSTALL AMR METER Phone Numbex: 763-786-SS42
Scheduled Date: 2017-06-17 Sc6eduled Time: 11:00:00
.�C,�I- � '1 I ��+
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-06-0�
ACITON TAI�N:
Status: In Progress Sabmitter Aas Been r
Contacted
Date Completed: Completed by:
' �c'iy o���a��ey
��� � �a 7��� �� �
' water De�sartrr,ent ��
6431 University Avenue IVE � � �3(�
Fr�rlley,MN 55432 �
7fi3-572-3566
1/we hereby authorize the City of Prid(ey and/or its emptoyees to do what is necessary to
replace fihe water meter. t understand chat the property owner is liabte for the water ltne from the main to the premise and al!imereor
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that�nay occur while doing this
operatiom. This to incJude,but not limited to vatves,pipin�walis,floors or the curb stop box and service line. la understand 1 am also requin
to abtain a permit prior to arry work,if necessary.
FINAL METER READtNG(old meterj ��� •• ��
r � 1
wame:�C�d�.,,�A1 ��'.�_ Address
Phone Num ' �"6 » tti �"�)'�ate� ., � 7,. / 7
�
Sfgnat�re LV"�tness Signature
OLD METER# _I�����
7
OLD READtNG��Z� • `����-- __
NEW�„�ER# II IIIIIIIIIIIIIIIIIII�I Ii� .
�
49226335
NEW READING_Q�
__ _ - ----
E�# ; Illllllllllllllllll�l E
` _� � 72227521
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINtSTRA170N �
(Ref�rd No 113,464,565,566,629,638,662,92Z,988, 1144,1156,i191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipa(system and arry house ar building for which the
application is made,the owner or+contractor shall�e required to obtain a permit for such oonnection,and shall pay a permit fee as provided in
Chapter 11 of ghis Code. After such connection has been made,the Water and Sewer Departmerrt shali be nottfied. it shall be un(awfui to cover
any connecting line urrtil an inspection has been made and sueh connection and the work inadent thRreto has been approved by the Crty as a
proper and suitable connection.
�02.06 REPAIRS AND MAINTEPIA4�ICE TO COPINECTIOtY
After the initiat connectiort has beert made to the water service curb stop box or the sewer tead at the property tine or a water senrice lead has
been extended to the property line for connecfion,the applicarrt,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main ta Che premises. ff the property owner
requests maintenance service ar repairs be performed by the City,the property owner shall be charged for the costs af ihe maiMenance and/or
repairs,including necessary street repairs at a rate set annualiy bg an administrafi+re policy. It shall be the responsibility of fihe appiicant,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris clearing or
root cutting and xo maintain the water service curb stop box for operability and at such height as wit(ensure that it remains above the finished
grade af the iand or property. (Ref 638,1156,1191)
� j �: