Meter Swap � Request Number: 16298
Public Works Division
Service Request r
Problem Address: 680 Ironton St Requested By: Carmen
DepArtment: WATER Address: No ac�ress ixovi�d
Problem/Issue: INSTALL AMR METER P6one Nwnber: 612-345-2�63
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Sche ed D�te• 2017- 7-13 Scheduled 1tme: 10:00:00
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. ACT10N NEEDED:
Created by: Wendy Hiatt Date Cres�ted: 2017-07-12
ACTION TAI�N:
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Status: In Progxess Submitter HasBeen �
Coutacted
Date Completed: Completed by: `
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Ci�ty of Fridley
' Water Departr�ent ��� (��'�
5431 University Avenue NE < <
Fridley,MN 55432
763-572-3566
i/we hereby authorize the City aF Fridley and/or its employees to do what is necessary to
repiace the water meter. l understand tfiat the property owner is liable for the water line from the main to the premis�and al!interio�
piumbing. (Per City code 402.06} 6 aiso hold the Cty of Fcidley and�ts employees harmless for any damages that may occur while doing this
operation. This to inctude,but not limited to valves,piping,�nralts,ftoors or the curb stop box and service Itne. In understand i am also required
to abtain a permit prior to any work,if necessary.
FINAL METER READING(ald meter)_ V � � `� V!� �
Name• ���U�� Address_�..(d�l J � ���V ��h_ ��.
Phone Number �'-II�'�`��� `�3 Ip 7 p�e �' �,� � 1��
�Si nature l "^�—
, +� Witness Signature
OLD METER#-_� � � t � t7�
OLD READING � � � � �3 �
NEW METER# I ` ��� lL !
NEW READING �
ERT# � � � � S �W t
fRIDLEY CiTY CODE
CHAPTER 4Q2.WATER,STORM WATER A1VD SANlTARY SEWER
ADMiNISTRATION
(Ref Ord NO 113,464,565,566,529,638,662,922,9$8,1144,1156,1191j
402.5 PERMiT FEE
Prior to constructi�g or repair of any water af sewer line connecting the existing municipal system and any house or buiiding fo�whith ihe
application is made,the owner or coritractor shali be required to obtain a permit for such connectio�,and shafl pay a permit fee as provided i�
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departme�t shall be natifisd. It sfiali be untawfui to cover
any connecting line unti{an inspettion has heen made and sucfi connection and the wark incident thereto has been approved by the City as a
groper and suitable connection.
d.02.06 REPAIRS AMD MAINTENANCE TO COPINEC7'ION
After the initiai con�ection has been made to tfie water service curb stop box or the sewer lead at the proper[y line or a water service tead has
been extended to the property line for connection,the applicant,owner,or occuparit or user of such premises sha{I be tiabSe for all repairs
required to any water tine and sewer lines necessary#o�connection of the premises from the main to the premises. 4f the property owner
requests mairrtenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance andja�
repairs,including necessary street repairs at a rate set annually by a�admi�istrative policy. !t shall be the responsibility o�f the applicant,
owner,occupant or user to perform standard maintenance of the sewer service�ine f�om the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operabil'ity and at such height as will ensure that it remains above the�nsshed
grade of the tand or property. (Ref 638,1156,1191)
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City of Fridley
Water Department
Address � ���d1J
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Name � �-1�-�-.
Date �^�0 1
Old Meter Number ��� 8��-�1
Old Meter Reading ��� ��
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Replacement No. �
Replacement Reading �
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Replacement Make ���
Remarks: O`D ,�N1.�; �'`
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Signed
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