Meter Swap �
Request Number: 16514
Public works Division
Service Request
Problem Address: 141 Hartman Circle Requested By: Martin Gavic
Departme�: WATER Address: No address provided
Problem/Issue: INSTALLAMRMETER PhoneNumber: 763-571-1219
Scheduled Date: 20 7-08-02 5c6ednled 13me: 11:00:00
M'� I� ��
ACIION NEEDED:
Created by: Beth Kondrick D�te Created: 2017-0'7-31
ACTION TA�N:
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Status: In Progress Submitter Has Been r,
Contacted
Date Completed: Completed by:
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M�a#ea-�e�artanent �
6431 ll�iversity Avenue NE
fr6dley,MN 55432
7f3-572-3565
t/we hereby authorize the�ty of Fridfey artd/or its em�loyees to do+ahat is necessary to
replace the water meter. 1 understand that the property owner is liabie for the arater line from the main to the premise and ail irnterior
plumbing. �Per�L'�:y code 402A6) 1 also hold the City of Fridley ar►d/�ts emp{oyees harmtess for arry damages that rnay occur while daing this
operation. This to include,but aot limited to valves,pipin�watts,floors or the curb stop box and service line. ln understand 1 am also require
to abtain a perRs"st prior to arry work,if necessary.
FiR1Al METER READll1tG(old mete�� � � v " �
Name:_�=1�'�Y 1�� U�'"�� Address__ �- 1,1 �i����'�+ Cj�
Pha�e Nu be�'rc�� I-����1- ` Date � � (i ��
Signature Witness Signature
OLD METER# ��a�°��� �
OLD READlNG � �V
NEW METER# - 4����� �
NEW RfADING �
���_ � 2�}� `-�5��
FRIDLEY CiTY CODE
CHA�TER 402.WATER,STORAA 1NATER AND SANITARY SEWER
ADMlMISTRATtON
{lief Ord Alo 113,464,565,566, 629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or buiiding for which the
application is made,the rnaner or contractor shall be required to obtain a permit for such connection,and sha{t pay a permit fee as provided in
Lhapter 11 of this Code. After such connection has bee�made,the Water and Sewer Departmerrt shall be notified. tt shal!be urtiawfu!to cove�
arry connecCing li�e uati[an inspection has been made and such connection and the woric inciderrC thereto has been approved by 3fie Crty as a
proper and suita6fe connection.
4Q2.06 REPA(RS APtD MAiNTEAIANCE TO CONNECTION
After the initiat connection has been made to the vaater sesvice a,rb stop box or the sewer lead at the property line or a water service dead has
been extended tu the property line for connection,the applicarit,owner,or occuparrt ar user af such premises sha{{be liabte for afi repairs
required to any water line and sewer tines necessary#or con�ectiort of the premises from the main to the premises. (f the properCy owner
requests mairrtenance service or repairs be performed�y the�ty,the property owner shail be charged for the costs of the mair�tenance and/ar
repairs,inctuding necessary street repairs at a rate set annually by an administratsve poticy. It sfiaN be the responsibility of the applicar�t,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including debris dearing or
root cutti�g and to mairrtain Lhe water senrice curb stop box for operability and at such height as w+it ensure that it remains above the finished
grade of the fand or property. (Ref 638,1156,1191)