Meter Swap y Request Number: 15244
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Problem Address: 7092 Hickory Dr Requested By: Don Foreman
Department: WA'IER Addreaa: No address p�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 5�2-0259
Schednled Dxte: 2017-OS-10 5chednled'1Time: 11:30:00
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ACITON NEEDED:
Created by: Wc�y Hiatt Date Created: 201'7-OS-09
AClION TAI�N: � C�
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Status: 1n Progress Snbmitter Has Been r
Co�acted
Date Completed: �, �/� � 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 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 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the wrb stop box and servke line. In understand I am afso required
to obtain a permit prior to any work,if necessary.
FINAL METER READIPIG(old meter) � `� ���./
Name: �,laV�- ��r!E�A'l,(,�.�'1 Address �� c �
Phone Number J��� �eL� ` p� J — L� ! ��!�—
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Signature Witness Signature
OLD METER# ��� �J lJ��
OLD READING ��� �J�
NEW METER# _ � (a�� ��J�
NEW READING v
ERT# � l 6 eG. l V l�
FRIOLEY CIT1!CODE
CHAPTER 402.WATER,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 any water of sewer line connecting the existing municipal system and ar�y house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided tn
Chapter 11 of this Code. After such connectlon has been made,the Water and Sewer Department shall be notlfied. It shall be unlawful to cover
any connecting tine until an inspection has been made and such connectioa 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 lead at the property line or a water se�lead has
been exCended to the property line for connection,the applicant,owner,or occupant or user aF wch premises shall be liabie for ali repalrs
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 property owner shali be charged for the costs of the mairKenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. 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 main including debris clea�ing or
root cutting and to maintain the water senrice a,�rb stop box for operabi{ity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)