Meter Swap s ,
Request Number: 16210
Public Works Division
Service Request
Problem Address: 576 Hugo St Requested By: Mark
Department: WATER Address: No address provi�d
Problem/Issue: INSTALL AMR ME1ER Phone Number: 763-269-7604
SchedWed Date: 2017-07-Ob Scheduled 13me: 11:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-06-30
ACTTON T.AI�N:
Status: In Progress Sabmitter Has Been r,
Contacted
Date Completed: Completed by:
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' City o#Fridley �.�j
Water Department SC -�" ��� �
6431 University Avenue NE
Fridiey,MN 55432
763-572-3566
��`"�e herebq authorize the City of Frid{ey and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable far the water line from the main to the premise and a8 ir�terior
plumbing. (Per City code 402.06) 1 also hold the C'ity of Fridley and/'rts employees harmless for arry damages that may occur while doing this
operatian. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand l am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIWG(old meter) �� — � r l�CJ
Name•___ Address �
Phone Number '" p�,;�` � �' `�
Signature Witness Signature
OLD METER# __�� � �`'� ��
OlD READING lJ��cJ '� t � (�J
NEW MfTER# �"\-J���� �
NEW READING�__/
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ERT# � v� ` ��,''��
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 iine connecting the existing municipal system and any house or buflding 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 in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shalt be notified. It shait be untawfu{to cover
any connecting line until an inspedion has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitabie connection.
402.06 REPAIRS APID MA(NTENANCE TO CONNECTION
After the initial connection has been made to the water servPce curb stop box or the sewer lead at the property line or a water service iead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for aii repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises, tF the property owner
requests mair�tenance service or repairs be perFormed by the�ty,the property owner shali be charged for the costs of the mairrtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris ciearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)