Meter Swap Request Number: 15396
Public Works Division
Service Request
Problem Address: 115 Glen Creek Rd Requested By: Atisha Spinelli
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMIt METER Phone Number: 651-253-1593
Scheduled Date: 2017-OS-22 SchedW ed 1lme: 11:30:00
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ACTION NEEDED:
Created by: Wendy Hiatt DAte Created: 2017-OS-17
ACTION TAKEN: ,,_
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Status: 1n Progress Snbmitter Has Been r,
Contacted
Date Completed: �, �� ._..�� '"� Completed by: ` ���
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City of Fridley
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� Water Department �� � �/�/►Q
6431 University Avenue NE �� �
Fridley,MN 55432
763-5723566
�1�"+e hereby authorize the City of Fridley andior its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is tiable for the water line from the main to the premtse and alt interior
plumbing. (Per City code 402.06) f also hofd the City of Fridley andjits employees harm{ess for any damages that may occur while doing this
operation. This to include,but not limited to vaives,piping,walls,floors or the curb stop box and service line. In understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oid meter) l V� ��� ��
Name: �� l�� �l f�1 Q,�'�G Address l.� ✓ l.9'��1�.i1 l� � �� •
Phone Number �J ( � ���J '" ! ✓ �!� Date__ �" � o�-" �` t
Si nature �'�`
� Witness Signature
OLD METER# � ��� ���
OLD READING �`�� � v ✓ v
NEW METER# `� �� �U �, b
NEW READING v
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FRIDLEY CIT1t CODE
CHAPTER 4Q2.WATER,STORM WATER AND SANITARY SEdVER
ADMlNtSTRATION
(Ref Ord No 113,464,565,566,529,638,662,922,988,1144,1156,1191}
4�2.5 PERMIT FEE
Prior to constructing or repair of any water of sQwec line connecting the existing municipa!system and arry house or buiidirig for which the
application is made,the owner or contractor shall be required to obtain a pe�mit for such connection,and shall pay a permit fee as provided in
Chapter 11 af this Code. After such connection has been made,the Water and Sewer Departmerrt shall ix notified, it shall be unlawfui to cover
am►connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitahle connection.
402.Q6 REPAIRS APID MAINTENANCE TO CONPtEC170N
After t6e initial connection has been made to the water service curb stop hox or the sewer lead at the property line or a water service tead fias
been extended to the property line for connection,the appiicant,owner,or occuparrt or user of such premises sha116e liabie for aN repairs
required to any water line and sewer lines necessary for connection af the premises from tfie main to the premises. If the property owner
requests maintenance service or repairs be perFormed by the C'sty,the property owner shal)be charged for the costs of the mairrtenance andjor
repairs,including necessary street repairs at a rate set annualty by an administrative policy. It shaq be the responsibi{ity of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service fine from the premises to the main induding debris ciearing or
roat wtting and to mairrtain the water service wrb stop box for operabitity and at such heigfrt as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j
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