Meter Swap i
r
Request Number: 15840
Pubtic Works Division
Service Request
Problem Address: 534 Fairmont St Requested By: Jodi
Departmevt: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME'IER Phone Number: 763-229-3997
Scheduled Date: 2 -06-23 Sct�eduled Time: 11:00:00
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ACTION NEEDED:
Created by: Beth Ko�irick Date Created: 2017-06-0?
ACTION TAI�N:
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Status: In Progress Snbmitter Has Been r,
Coutacted
Date Completed: Completed by:
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643�l�reiversrty Avenrae NE � � � /�/ i/
Y Fa�dley,MN 55432 �'f" �D �•%
763-572-356�►
�Ow� hereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
repiace the water metere t understand that the�ro�erty owner is liabte for the water line from the main to the premise and all irtterior
plumbing. (Per�'rCy code�02.06j B also hold the City af Fridtey and/its employees harmless fo�any damages that may occur while doing this
operatiam. This io indude,but not lim'rted to va(ves,pipireg,wal[s,floors or the curb stop box and seruice line. In understand I ans aiso require
to obtain a permit prior to arn/work,if necessary.
FINAL METER READfA{G(oid meter) ��� ���
Name:sC1� � Address ��"1 ��,�r`(Ir�f/�,"�- �"'
Phone 9Yumber��� �"l� �� p� �j'' ��" ��
�/; Signature Witness Signature
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OLD METER# ������2"
OLD READtNi3 � 1�� ��
NEW METER# � +��c.��l'`�1 �
NEW READING� 1
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CFIAP'TER�02.WATER,SCORM WATER AND SAi111TARY SEWER
ADMtNISTRATION �
(�tef Ord No 113j 4E�,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMiT FEE
Prior tv constructing or repair af any water of sewer fine connecting the euisting municipal system and any house or building for which the
appl�cation is made,the owner ar contractor shall be required to obtain a permit for such connectian,and shait pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Wlater and Sewer Departmerrt shall be notified. Ifi shall 6e unfawfut ta cover
any connecting line urrtit an inspection has 6een made and such connection and the work+ncident thereto has been approved by the City as a
proper and suitabie connection.
402A6 REPAIRS AMD MAINTENANCE TO COAfAIECTiON
After the inifiiat connection has been made to the water service curb stop boec or the sewer iead at the property line or a water servic�lead has
6een extended to fihe property(ine for connection,the applicarit,owner,�ar occuparn or user of such premises shall be liabie frn atl repairs
required to any water line and sewer tirties necessary for connection of the premises from the main to the premises. tf the properiy owner
requests maintenance service or repairs be performed by the Crty,the property owner sha!!be charged for the casts of the mairrtenance andjor
repairs,including necessary street repairs at a rate set annuafty by an administrative policy. It shall be the responsibility af the applicasst,
owner,occupant or user to perform standard mairrtenance of the sewer service Gne from tftie premises to the main including debris dearing o�
root cutting and to maintain the water senrice curb stap box fo�operability and at such height as witl ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j