Meter Swap .. ���,�����e„ ��" S/�3D 02
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�era�e�-�epar�ment � 2
' �43�.L9�siversity Avencae N� �� G!�'�
FrBslley,MN 55�32
763-5�2-3566
',°"�� hereby authorize the City of Fridley and/or its employees to sio what is necessary to
replace the water meter. 1 understand that the property owner is liabie for tfie water line from the main to the premise and all ir�terior
plumbing. {Per sity sode 4�2.�6j 0 also hold the C"Rty af Fridley andJits empfoyees harmiess for arry damages that may occur while doing this
operation. This to include,but not limited to vatves,piping,rnral[s,floors or the curb stop box artd service line. ln understand 1 am aiso require
to obtain a penmit preor to any wortc,if necessary.
F4tYAL METER READf9YG(old meter) r� v v � � "
Plame: ��L r\� Acidress �� W 1� v � ��
Phone Number���^y��p"� 1 ' { � Date � � ` � �
//\/ S�g� Witness Sigrtafiure
OLD METER# :�f ���" 1 �J J U
OLD RfADtNG � � 1r V
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�iEw METER# �[� J��l� J E�
NEW READtNG �
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�R4DLEY C{TY CODE
CNA�'CER 4U2.WA'fER,STORM WATER AND SANITAIiY SEWER
ADMINISTRA,TION
(Ref Ord No 113,464,565,566, 629,638,662,922,988,1144,1156,1191�
�02.5 PERMCi FEE
� Priar to�onstructing ar repair of any water af sewer line connecting the existing municipal sysiem artd arry house or bui(ding for wrhich the
apptication is made,the owner or contractor shail be required to otrtain a permit for such connection,and shaH pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Searer Department shall be nofified. (t shall be uniawfui to cover
any connecting li�e unti!an inspection has been made and such connectian and the wor{c incident thereto has been approved by the City as a
proper and suitahte connection.
402.06 REPAIRS APiD MAiPITENANCE TO COMNECTIOIY
After the initial connection has been made to the water service curb stop box or the searer lead at the property line or a avater seroice Iead has
been extended to fihe p�operty line for connection,the applica►rt,owner,or occuparrt or user of such premises shall be 3iable for all repairs
required to any water tine and sewer(ines necessary for connection of the premises from the main to the premises. If the property owner
requests mairnenance service or repairs be performed by the City,the p�operty owner shall be cfiarged for the costs of the maintenance andJor
repairs,including necessary street repairs at a rate set annualty by an administrative policy. It shal!be#he respvnsibi{ity of tfie appiipnt,
owner,occupant ar user to perform standard maintenance of the sewer service line from the premises to the main inctuding debris ctearing or
root�utting and to maintain the+,vater service curb stop hox for operability and at such height as will ensure that it remains al�ove the finished
grade af the land or property. (Ref 638,1156,1191j
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• Request Number: 16559
Public works Division
Service Request
Problem Address: 500 Ironton St Reqnested By: Amelia
Departme�: WA1ER Address: No ac�ress provided
Problemflssue: INSTALL AMR METER Phone Number: 763-486-9111
Sc6eduled DAte: 017-08-11 Schednled 1lme: 09:00:00
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r.c.
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-08-02
ACTION TAI�N: �p
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Status: In Progress Submitter Has Been r,
Contacted
Date Completed: Completed by:
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