Meter Swap /�n � / � �
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� `�" Re uest Number: 12724
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Public works Division
Service Request
Problem Address: 1301 Fireside Dr Req�sted By: Al Booth
De�au�tme�: WA1ER Addresa: No address provided
Pro�em/tssu: INSTALI.AMR METER Phone Number: 612-207-8682
Sc�eiuled Date: 2017-01-09 Sc6edaled 1I�: 07:00:00
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ACIION NEEDED:
c��ea�: w�y x��cc n�c�c���a: 2oi�-oi-oa
AC7ION TAI�N:
�`0' '' "�%� 'l�%'
.
Stataa: In Progresa S'bmitter H»Bee� r
CoMacted
Date Completed: ��.Q ,,. 1"'7' Completed by: .
1
City of Fridley
Water Department
6431 University Avenue NE 3c���✓ �3��v C
- Fridley, MN 55432 /
. 763-572-3566 �� � ���
�/We hereby authorize the Cityr af Fridiey and/or its empioyees to do what is necessary to
repiace the water meter. !understand that tfie property owner is liable for the water line from the main to the premise aed all interior
plumbing. (Per City code�02.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur white doing this
operation. This to include,but not limited to valves,piping,wa{Is,ffoors or the curb stop box and service line. In understand i am also required
to obtain a permit prios to any work,if necessary.
3a��5�.�-% c.�
FIAIAL METER READING(old meter)
Name: � ��'� Address i�d� �1 V'L°s i�� �.J l�'•
,1
Phone Number ���� � ` " U���Date `� l� ��
�Signature� -,� Wiiness Signature ��
OLD METER# �� ����� J
OLD READIAIG �����1��
NEW METER# U 4�`� ""' " `
NEW READtNG �
ERT# � v O� � i 1��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATiON
(Ref Ord No 113,464,565,556,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer tir�e wnnecting the existing municipal system and arry house or butldi�for whid�the
application is made,the owner or cornractor shait be required to obtai�a permit for such conrtection,and shal!pay a pern�it fee as providec{in
Chapter il af this Code. After such connection has been made,the Water and Sewer Departmerrt shaii be notified. tt shall be unlawful to cover
any connecting line until an inspection fias been made and such connection and the wo�Ic indderrt thereto has bee�approved by the CiCy as a
proper and suitable connection.
402.06 REPAIRS AND MAINTEMAI1fCE TO CONNECTION
After the initiat connection fias been made to the water service evrb stop box or the sewer lead at the prope�ty ttne or a water senrice lead has
been extended to the property line for wnnection,the appiicaM,owner,or accupant or user oF wch premises shaii be fiabie for ali 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 mairrtenance service or repairs be perFormed by the City,the property owner shalt be charged for the costs of the mair►tenance and/or �
repairs,including necessary street repairs at a rate sQt annuaify by an administrative policy. It shali be the responsibility of the applicarrt,
ow�er,occuparrt or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box fo�operability and at such height as wifi ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)