Meter Swap ,;_
ar�Qr
Fridley
Request Number. 17903
P�ic works Dh�iaion '
Sezvke R,equeat
Pro�em Addreas: 295 IroMon St Reqnested By:
Departmeet: WAZER Address: ' No address provided
Prable�e/Issne: INSTALL AMR METER P6o�Number:
Schednled Date: Sc6edeled Ti�:
ACIION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2018-03-08
ACIION TAKEN:
Ststtua: tn Progress �bmitter Has Been r
CoMacted
Dnte Completed: Completed by:
/�lwc�. �`.!�/� /'�-�
. . � f�a�`
. • City of Fridfey '3�9�,,�l�v��
Water Department
6431 University Avenue NE
Fridley,MN 55432
T63-5723566
IJwe hereby authorize the C'tty of Fridley and/or its employees to do what is necessary to
repiace the water meter. !understand that the property owner is iiable for the water line from the main to the premise and all interior
plumbing. (Per�ty code 402.06) I also bold the City of Fridley and/its employees harmless for any damages that maY occur while doing this
operation. This to indude,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to anY work,if necessary.
FIPIAL METER READING(old meter)
Name: Address o�S .1ro..-�on S�
Phone Number Date_ /,!M-� .� v�7/�
Signature Witness Signature � �
OLD METER#_ 0�4��a(p0 SIZE & STYLE ICirdel
OLD READING I S� � �¢� -- � .� ��
NEW METER# '��3 Ss o a� � 1" HEX
NEW READING � 1�4" ELIPTICAL or HEX
ERT# �a3? �i3(o�l 2" EUPTICAL or HEX
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 ariy water of sewer line connecting the existing municipal system and amr fia�se or IwiWing for which the
appiication is made,the owner or contractor shail be required to obtain a permit for such connection,and shail pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notitied. It shall be uniawtal to cover
any connecting line untii an inspection has been made and such connection and the wnrk incident thereto has been approved by the CRy as a
proper and suitabie connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC770N
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for cortnection,the applicarrt,owner,or occuparit or user of such premises shaii be fiable for all re�irs
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 mairrtenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,inciuding necessary street repatrs at a rate set annualiy by an administrative policy. tt shatl be the responsibitity aE the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearlr�g or
root cutting and to maintain 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)
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