Meter Swap , ^ Request Number: 15144
Public works Division
Service Request
Problem Address: 6809 Hickory St Requested By: Lois Berg
Department: WATER Address: No ad�ess provi�d
Problemllssue: INSTALL AMR ME'IEIi Phone Nnmber: 5�1-1667
Sc6eduled Date: 2017-OS-08 Sc6edule�1lme: 11:00:00
. �� a.M
ACTION NEEDED:
Crexted by: Wendy Histt Date Cresited: 2017-OS-04
ACIION TAI�N:
�5� ���� ��Z
Status: In Progress 5nbmitter Has Been r,
Cont�ted
Date Completed: �,_ �— �� Completed by: s���o
� �� � ��� �0 '�I
r 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 proemise and all interior
plumbing. (Per City code 402.06) I also hoid the City of Fridiey and/its employees harmtess for any damages that may ouur while doieg this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In u�derstand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � " � O ` - �
�5 q
Name• W�, r�� _ Address,�� U D " ��`���^+ 7 �-
PhoneNumber �� ' � ��11� � Date ��` CJ � � `
Signature Witness Signature �—
OLD METER# �v� �� ���
OLD READING v��O �J �
NEW METER# 1 {D� � � � I
NEW READING 0
ERT# � ' 1 � r � � i
FRIDLEY CITY 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 any house or buildtng 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 ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shali be unlawful to cover
any conrtecting line untt!an inspection has been made and such connection 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 sewice lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for 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 of the mair�tenance and/or
repairs,induding necessary street repairs at a rate set annually by an administrative policy. R shall be the responsibility o�f the applicarit,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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� City of Fridiey '
Water Department
Address C� �� � i G 1�, �v-
Name �C715
Date ��.." 'f'Q c�
� LS
Old Meter Number �c�l�(� ��_
Old Meter Reading t ��
Replacement No:_ p�.�j �.� ��
Replacement Reading �
Replacement Make p,�. �r
Remarks: '�'�QQf,p /�.�;�,_
Signed