Meter Swap _ Request Number: 15284
Public Works Division
Service Request
Problem�4ddress: 11Z Glen Creek Rd Requested By: Be�c�ict Ho
Deputmeut: WATER Address: No address providcd
Problew/Iesue: IN5TALL AMR METER Phoae Number: T63-S'I1•5216
Schednled 1'�te: 2017-05-17 5chednled 1lme: Ol:00:00
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AG"TION NEEDEDs
Create�by: Bcth Koadtick 1)ate Created; 2017-OS-11
ACTiON TA��' � � �
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Status: �pro��s$ Snbwittcr Has Been r,
Contacted
Date Com�eted: Completed by:
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City of Fridley
' Water Department �� �?) �(p
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�J�+�+e hereby authorize the Ctty of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all itrterio�
plumbing. (Per City code 402.06) I also hold the City of Fridley andrts empioyees harmless for any damages that may occur while doing thIs
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to oirtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj � `� �� ��
F � I Z �I� Cx�e��
Name• ` qddress
Phone Number f�iV�`�1.�`"'(/�j�Q Date �� 1�� � /
Signature Witness Signature
OLD METER# _ 1� ���7�—I��
OLD READING ��Z�� D
NEW METER# � t����
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NEW READING �
ERT# � r C�/ `�`-'��
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to conmucting or repair of any water of sewer line connecting the existing municipal system and ariy house or building fo�which#he
application is made,the owner or cor�tractor shall be required to obtain a permiC for such connection,and shatl pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerit shall be notified. It shail be unlawful to cover
any conneding line until an inspection has 6een made and such connection and the work inciderit thereto has been approved by the Ctty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connectioa,the applicant,owner,or occupern or user af such premises shall be tiabte for alt 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 mairitenance service or repairs be performed by the C'ity,the property owner shall be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicar�t,
owner,occupant or user to perform standard mairrtenance of the sewer service line f�om the premises to fihe main including debris dea�ng or
root cutting and to maintain the water service curb stop box fo�operability and at wch height as will ensure that it remair�s above the finished
grade of the land or property. (Ref 638,1156,1191)