Meter Swap � ' Request Number: 15503
Public works Division
Seivice Request
Problem Address: 6802 Hickory St Requested By: Acm�Bischo
Departmeat: WATFR Address: No a�reas provi�d
Problea�/Issue: INSTALL AMR ME1ER Phone Number: 763-229-4821
Schednled Date: 2017-06- 1 Schednle�1i�e: 10:30:0(1
ST �
ACITON NEEDED:
Created by: Beth Kondrick D�te Created: 2017-OS-22
ACTION TAK�N:
....._._....._�..����....................�-1'�'�...-.-._................._ __ _.__ .....____._.
Status: In Pro�ress Snbmitter Har Been r..
Contacted
llnte Compfeted: Completed by:
Honrs �
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���,�f�r���ey �j b� -� ���� �� 'c�
, w�ter oe�a�tme��
, t4319�niversi�Avenue NE � -� //��
Fa�dLey, NlP1 55432 �F
763-572-3566
eI'iNe hereby authorize the C'�ty af Fridley as�d/or its empioyees to do wfiat is necessary to
replace the water meter. I understand chat the�roperty owner is liabte for the�n+ater line from the anain to the premise and all irtterior
plumbing. (Per C'�ty cade 402.06j f also hold the City of Fridley and�ts employees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to vatves.piping,wal(s,floors or the wrb stop box and sen+ice line. In undersrand 1 am also requirr
to afitain a permit prior to any work,if necessary.
FiNA!METER READtNG(ald meter)_ 4 v� ���v
��, "' ,�•�____ �d� � Z � ��--
Name: �, �O''�(� LJ
n � ,�1 ,,
Phone Numtser � J�� ��' +✓vl e �'" � b�
�Sig�a Witness Signature
,i,, � � � ��� �
' OL@ METEK#
OLD READtNG ` rZ� � �`�Q
NEWMETER# -F I�Z���b
NEW READtNG �
E�# �1222�1 `L� 3
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINlSTRATION �
(Ref Ord No 113,464,565,566,629,638,662,922,988,11�44,1156,1191j
402.5 PERMiT FEE
Prior to canstruding or repair of any water of sewer line connecting the existing municipa!s�{stem and arry house or buiiding for which the
application is made,the owner or coritractor shafl be required to obtain a permit for such connection,and shafi pay a penmit fee as provided in
Chapter 11 of this Cade. After such connection has been made,the Water and Sewer Departmerrt shali be notified. It shall be unlawful to cover
any connecting line urrtil an inspection has heen made and such cannection and the work incident thereto has been approved by#he�ty as a
proper end suitable connection.
402.06 REPAIRS AND 11AAlNTEMAPtC€TO COMNECTfOAi
After the initiat connection has been made to the water ser+rice curb stop boK or the sewer tead at the property line or a water service lead has
been 2utended to the property line for connedion,the applicant,owner,or occupant or user of such premises shali be liahte for alt repairs
required to any water line and sewer Iines necessary#or connection of the premises from the main to the premises. If the property owner
requests maintenance senrice or repairs be pesformed by the City,the properry owner shali be charged for the casts of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annualiy by an administrafive pa4iry. It shall be the responsibility af the applicant,
owner,occupant or user to perForm standard mair�tenance of the sewer senrice line from the premises to the main includfng debris dearing or
raot cutting end to mairrtain the water service curb stop box for operability and at such height as wiii ensure that it remains above the finished
grade af the land or property. (Ref 638,1156,1191)