Meter Swap _ 4 Request Number: 15308
Public Works Division
Service Request
Probtem Address: 123 Glen Creek Rd Requested By: Carmen
Departmeat: WA'IER A�ress: No address provided
Problem/Isaues INSTALL AMR METER Fhone Number: 571-3434
Schednla�Date: 2017-OS-19 � Sc6ednied Tlme: 08:00:00
t
ACIION NEEDED:
Crente�by: Weady Hiatt Date Creatad: 2017-OS-12
ACIION TAKEN:
�Y`��� � ��
Status: In Progress Snbmitter Has Been �..
Contacted
Ds�te Completed: Campleted by:
� ^ ��' �� "_'��'`�'
�0 � � 3 � �
. " 3�-� - �� ��-�o�� f
City of Fridley
Water Department
6431 University Avenue NE
Fridley,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. I understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06j I also hoid the City of Fridley and/its employees harmless for any damages that may oaur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senric�line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FfNAL METER READiNG(old meter) v� �� ��
Name: �_�M �'►�J' � Address � �� �''�l ���1 �� ��
Phone Number_���� � `�� Date___ L, ��~ �
Signature Witness Signature �1�'��
OLD METER#
1 �� ��1 �3 � �
OLD READING � I Y�� �JD
.
NEW METER# ��0�� I�
NEW READING v
ERT#� � �1 �� ('�
FRiDLEY CITY CODE
CHAP'i'ER 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 construding or repair of any water of sewer(ine connecting the extsting municipal system and any house or building for whic�the
appiication is made,the owner or corrtrador shali be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to cover
any wnnecting fine uritil an inspection has been made and such wnnection and the work incident thereto has been approved by the City 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 iead at the property line or a water service lead has
been extended to the property line for co�nection,the appiicant,awner,or acupant or user af such premises shall be liable for all repairs
requi�ed to any water line and sewer lines necessary far 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 property owner shall be charged for the costs af tfie mairrtenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the mai�intluding debris ctearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the fiaished
grade of the land or property. (Ref 638,1156,1191)