Meter Swap � Request Number: 16142
Public Works Division
Service Request
Problem A�ddress: 8141,Fairxnont Circle Requested By: Tim Arnold
Departmeet: WA1ER Addresa: No address provided
Problem/Isaue: INSTALL AMR METEIt P6one Number: 763-443-8119
ScheduledDate• 2017-07-14 ScMednled'Rme: 07:00:00
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ACIION NEEDED:
Created by: Wernly Hiatt Dxte Created: . 2017-06-26
ACTTON TAI�N:
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Status: Tn Progress Submitter Has Been �,
Contacted
Date Completed: � ` I u_ ( � Completed by: � ��
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City of Fridley ��� /��/�I
Water Department �� �
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
��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 liabie 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 andrts employees harmless for am/damages that may occur while doing this
operation. This to include,but not limited to valves,piping,watis,floors or the curb stop box and service line. In understand t am also required
to obtain a permit prior to any work,if neceSsary.
FINAL METER READING(old meter) �O� � � ��
Name: ��� 1 '� �l.(� Address _ [��1"'1 f L"7J1�.���� �fi�L��
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Phone Number ��� ��� �J � ��� D� � — 1 � � '�
xSignature Witness Signature
OLD METER# � � �� � �
OLD READING �,O � � � � O
NEW METER# ��✓� ��� �
NEW READING �./
ERT#_ �d�- i�� C)� tY�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord IYo 113,464,565,565,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shal(be notified. Ft shall be unlawful to cover
any connecting line until an inspection has been made and wth connection and the work inctdent thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the i�itial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicant,owne�,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 to the premises. if the property owner
requests maintenance service or repairs be performed by the City,the properly 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 poliry. It shali be the responsibility of the applicarit,
owner,occupant or user to perform standard mair►tenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above tNe�nished
grade of the land or property. (Ref 638,1156,1191)
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