Meter Swap . � Request Number: 12601
Y
PU�C wOTkS DIV1S10II
SCI'V1C@ R@(]l1ESt
Problem Address: 7391 Jackson St Requeffited Bys Donna Kirch�er
Depnrtmeut: WA'IER ,�ddress: 7391 J�kson St
Fridley,MN SS432
Problemllssue: INSTALL ANIIt ME'IER Phone Nwnber: 612-84S-S 143
Sc6cd�ied IMte: 2017-OI-24 Se�edaled 1tme: O7:OQ:0(1
'i�'11-c S - � `�`
AGIION NEEDED:I�tall AMR
Creatcd by: Beth Kondrick Date Cre�ted: 2016-12-27
ACtION TAI�N:
�v "J�� 1�V �'�, �
Statua: In Progress 5ul�itter Aas Been 1.,
Cout�cted ,
Date Completed: �_ �j��t'7 Campleted by: �0.�
Cit�of Fridley
Water Department
6431 University�Avenue NE ������ �j��—'�}�,�.
Fridiey,MN 55432 �
' T63-57Z-3566 � � �v Q,�
i/we hereby authorize the City of Fridley and/or its esnployees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liable for the water{ine from the main to the premise and atl interior
plumbing. (Per City code 402.06j i alsu hold the City of Fridtey andjits employees harmiess for any slamages that may occur while doing this
operation. This to include,but not limrted to valves,piping,waiis,floors or the curb stop box and service line. in understand i am also required
to obtain a permit priar to any work,if necessary.
FIAIAL METER READiN6(oid meter) � '�" �" ���C./
Name• QGhv1c� 1�.���th�v" Address ��� � vG".�-�LSo'�— 5�--
Phone Nu ber ��L•- �s i-(5-- '�''��q"�7� Date 1 '� �-t"�-- t�
f
Signature Witness Signature ''�
OLD METER#�� -1� I �j ` �
OLD READtNG_ _�V�9� 7��
NEW METER# � � � � �� � �
NEW READtNG �
ERT# � v�� � -/ � �
FRiDLEY C171f CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATI�N
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house or buildir�gfor which the
application is made,the owner or corrtractor shal!be required to abtain 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 Department shali be�otif'ied. tt shaii be un4awful to caaer
any connecting line until an inspectio�has been made and such wnnection and the work inaderrt thereto has been approved by the Ciiy as a
proper and suitable connection.
402.06 REPAiRS AND MAINTENANCE TO CONNECTION
After the initiial connection has been made to the water service curb stop box or the sewer lead at the propetty line or a water servk:e lead has
been extended to the property line for connection,the applicant,oMrner,or accupant oc user af such premises shall be fiabie for aft repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the prem7ses. if the property owner
requests maicrtenance service or repairs be perFormed by the�ty,the property owner shali be charged for the costs of the mairKenance and/or
repairs,including necessary street repairs at a rete set annuaily by an administrative poliry. It shatt be the responsibility af the appticarrt,
owner,occupanit or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mai+rtain the water service curb stop box for operabifity and at such height as wiii ensure that�t remains ahove the finished
grade af the land or property. (Refi 638,1156,1191)