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Fridley
R�quest Number: 17S68
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Problc " es:: 423 ho�on St Request�d Hy: Macy
Dep�rteient: WK1ER A�d�ra�: No ad�tass ptavided
ProW em/bsae: INS1'ALL AMIt METER Pho�i�r:
Sc�edDate: 2018-01- Sc�aHl�dlfar 11:30:00
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Cn#edby: WendyHi�t D�eCre�ted: 2018-01-1t
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City of Fridley
Water Department ���S�'��v�
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridiey and/or its empioyees 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 premise and all irrterior
plumhing. {Per City code 4fl2.06) 1 also ho{d the City of Fridley andjits employees harmless for any damages that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and senrice line. In understand 1 am also required
to obtain a permit prior to arry work,if necessary.
FINAL METER READING(old meter) _Y�lS✓ L l(GV
- Name•� Address o � ld� ��in_ ,J�•
• Phone Number Date � � "V v �
�Si n t � Witness Signature `�
OLD METER# � ` vq�� _`-/ SIZE & STYLE(Circlel
OLD READING � �� ��a 5/ EX
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NEW METER# t��� � 4 �� 1" HEX
NEW READING � 1�4" ELiPTICAI or HEX
ERT# � � �a � � �3 2" ELIPTICAL or HEX
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITAEtY 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 cannecting the existing municipaf system and any fiause or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such wnnection,and shall pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Department shaii be notified. it shali be untawful to cover
any connecting li�e until 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 REPAfRS AND MAINTETiANCE TO CONNEC'T'ION
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 senrice lead has
been extended to the property line for connedion,the applicant,owner,or occupant or user of such premises shall be Itable for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premtses. 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 mai�rtenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,ouupant or user to perform standard maintenance of the sewer service line from the premises to the maln 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 638,1156,3191)