Meter Swap �
i Request Number: 16211
Public Works Division
Service Request
Problem Address: 480 Fairmont St Requested By: Justin
Dep�rtment: WA1ER Address: No address p�ovided
Problemllssue: INSTALL AMR METER Phone Number: 763-432-6337
Scheduled Date: 2017-07-10 Schednled 1lme: 02:00:00
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ACITON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-06-30
AG7ION TAI�N:
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Status: In Progress Submitter Has Been r,
Contacted
Date Completed: Completed by:
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� City of Fridley
' Water Department
6431 University Avenue NE ���� ����v,�
Fridley,MN 55432
763-572-3566 �)� ����
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��We hereby authorize the City of Fridley and/or 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 prem(se and all interior
plumbing. (Per City code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur whife doing this
operation. This to inctude,but not limited to valves,piping,walis,fioors or the curb stop box and senrice line. in understand 1 am also required
to obtain a permit prior to any work,if necessary. •
FIIVAL AAETER READING(old meter) � `� ��D
Piame: �J Address � r (��` 1' 16� �
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Phone Number �� � D�, 1� 4 ( •
J�1 S�g� Witness5ignature
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OLD METER# ��� ���
OLD READING �_ 1 � 2'��
NEW METER#_`�"l �j��� �
NEW READING�/
E�# �2�-[ 1 ���
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINfSTRATION
(Ref Ord No 113,464,565,566,629,638,652,922,988,1144,1156,1191)
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
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shail be notified. It shall be uniawful to cover
any connecting line untii 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 AAfD MAIPITENANCE TO COPINECTION
After the initial cos►nection has been made to the water seroice pirb y�tap box or the sewer lead at the property line or a water seroice lead has
been extended to the property line for connection,the applicarrt,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. Pf the property owner
requests maintenance service or repairs be performed by the City,the property owner shail be charged for the costs of the maint•eenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupa�t or user to perform standard mai+�tenance of the sewer service line from the premises to the main induding debris ciearing or
root cutting and to mairrtain the water service curb stop box for operabil'�ty and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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City of Fridley
Water De�artment
Address_ �'� �(� �i.1!'rvib��,.
Name � V 5 5 e � I /�'� ��I^ -
Date_ � a ~ � �-- d �
Old Meter Number � - l �vZ��
Old Meter Reading v� � ��0
Repl.acement No. r � g ��j
Replacement Reading �
Replacement Make �0.d- � �
Remarks: D1Jil_,✓/�t��Y
Signed
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