Meter Swap 4
. Request Number: 14969
Public Works Division
Service Request
Problem Address: 165 Hartman Circle Requested By: Jolm
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone 1�lumber: 763-516-2588
Schegla�"�s��ate: 2017-04-27 Sc6edaled 1Ime: 11:00:00
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AG IION NEEDED:
Created by: We�y Hiatt Date Created: 2017-04-26
ACIION TAI�N:
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Statua: In progress �bsnitter Has Been r
Coatscted
Dxte Completed: � , ��^ r� Completed by: ����
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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 cb what is necessary to
repiace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley andjits employees harmless for any damages that may oc�cur while doing this
operation. This to include,but not limited to vafves,pipin�walls,floors or the curb stop box and service line. lo understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READiN6(old meter) �� i � ��`�
Name• �O��- Address ��� Tl�G�,P/l lJ1(�(✓Y�i
Phone Number �lY� " �(� "�i �� Date `•���� " ��
Si nature ��
g �tness Signature
OLD METER# V 1/�� ��/ ��� �
OLD READING L� i�� v W
NEW METER# ` I 0'�b V� 1 �
NEW READING �
ERT# �d��C2 � 8
FRIDLEY CITY CODE
CHAPTER 4U2.WA7ER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer line connecting the existing municipal system and arry house o�building for which the
appiication is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shaii be notified. It shail be unlawfui to cover
any connecting line until an inspection has been made and such tonnection and the work incident thereto has been approv¢d by the City as a
proper and witab4e connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEGTION
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 sen�ke lead has
been extended to the property tine for connection,the applicant,owner,or occupant or user of such premises shall be tiable for ali repairs
required to any water line and sewer lines necessary for wnnection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,the properiy owner sfial{be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility af the applicant,
owner,occupant or user to perform standard maiMenance of the sewer service line from the premises to the main including debris clearing ar
root cutting and to maintain the water senrice curb stop box for operability and at such height as wil!ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)