Meter Swap ` Request Number: 16556
Public Works Division
Service Request
Problem A,ddress: 6933 Hickory Dr Requested By: Karen Sctilagel
Department: WA'IER Address: No address provi�d
Problem/Issue: INSTALL AMR ME1ER Phone Number: 612-747-4176 �
Schedaled Date: 017-08-09 � Sc6ednled 1lme: 01:00:00
� 1
ACTION NEEDED:
Created by: Beth Kondrick DAte Created: 2017-08-01
ACTI N TAI�N:
�. I ��- -� ex�'�5��, �-�e�--
.................. ............�.................._........................................__.______._._ __.................._...._.............................___.__..__._._........._........._... .......�� ...... _.___..�..._.__
�
Status: In Progress 5ubmitter Has Been �..
Contacted
Date Completed: Completed by:
�"'�' �� � �61�
�
. �,�,,�{������ ��'�- �9'�.5"� - 1�%
�ate��e�a����� S��' ����
• �43�l�r�9versity!>er�nue 9VE
Fr4s!ley,MP! 55432
763-5?Z-3566
a�we hereby authorize the City of Fridley and/or its employees to sJo what is necessary to
replace che water meter. t understand that the property owner is iiable for the water line from the main to the premise and all irnerior
piumbing. (Per City code 40Z.06) I also hold the City of Fridley andrts empioyees harmless#or arry damages that may occur while doing this
operation. This to include,but nat limited to va(ves,pipin�walis,#loors or the curb stop boz and service line. In undeistand 1 em also require
to ahtain a persn'st prior to any work,if necessary.
FINAL METER READIAI6(old meterj �� ����
Plame: "'"���\ �C.�l �' Addre$s ���� C�Y' +�1"'
Phone Number � � "'_� !L'� p �0"� { — {�
�Signature Witness Signature
OLD METER# �� F� �� �
OLD READtNG �� �"��`��O
NEW MEt'ER# �'YVI� �p� ! � �
�11E1N R t V S�7 'T �00� �/`
EAD AIG
ERT# �� z�2 '��y f
fRiDLEY tITY CODE
CFIAPTER 402.WA1'ER,STORM WATER AND SANiTARY SEWER
AOM(IVlSTRATtOR!
�itef Ord No 113,464,565,566, 629,538,662,922,988,1144,1156,1191j
402.5 PERMlT FEE
� Prior to constsvcting ar repair of any water af sewer line connecting the existing municipal system and ar�y house or buitding for which the
appiication is made,the owner or coatractor shall be required to obtain a permit for such connedion,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shall be notified. Yt sfiaN be uniawfut to cover
any connecting line until an inspection has been made and such connection and the work inciderrt thereto has been approved hy tf�e City as a
psoper and suitabfe rnnnectivn.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has 6een made to the water service curb stop 6ox or the sewer lead at the property tine ur a water service iead has
been extended to the property line for connection,the appiicant,owner,or occuparrt ar user of such premises shali I�iiable for alt repairs
required to any water tine and sewer{ines necessary for connection of the premises from the main to the premises. If the property owner
requests mairrtenance service or repairs be performed by the�tyr,the property owner shall be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annualty by an administrative policy. It shall be the responsibitity of the app4icant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to tt�e main induding debris clearing or
root cutti�g and to maintain the water service curb stop box for aperability and et such height as will ensure that it remains above the�nished
grade af the land or property, (Ref 638,1156,1191J