Meter Swap - 'f Request Number: 12693
Public works Division
Service Request
Problem Addreaa: 7370 Jackson St Requested By: Mike Madsen
Departmeat: WA1F.R A�ddreas: No ad�ess provided
Problem/Issue: tNSTALLAMRME'IER P�eneNumber: 1-701-330-0810
Schedoled Date: 2017-01-21 Schedeled'Itme: 10:30:0(1
5 � S, �,
�,
- ACITON NEEDED:
Created by: Wendy Hi�t D�e Cre�ei: 2017-01-03
ACIYON T � `,
1 ,,�,A���� ��,�..��
_._...� _.__.__._�.__._._._�_____� ._.____.____
__ ...__._.___ .... S`������p...____..._.�_...__.._.._..\ _.. �..-�------
Stat�: In Progi�ess 3at�itter Ha�Been r. �"
Co�acted
Date Completed: Completed by: ���,�; d
��. �i
:�; •�,
. . � '-- �� . ,.,`�`�.._.. . Y .
� � � y
'�
City of Fridtey
Water Department ���p"��c�
6431 University Avenue NE ���� � -
�- ` Fridley,MN 55432 � � � ( �
763-572-3566 S�.j
�/We hereby authorize the City of Fridley and/or its employees 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 interior
plumbing. (Per City code 402.06) i also hold the C"rty of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop boz and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FHYAL ME R READfNG(ofd meter) ���� "`" � �
Name•�1 d � �� ��,�C 1r`�. �
�._ Ad ress � Z�� �
Phone Number �� W 1'� tJ���_ Date �••�� ��
Signature��.��'` --�' Witness Signature , ��
OLD METER#�` �� l�1
OLD READiNG �/"���`/ `tj��
d
NEWMETER# ��������
NEW READING �
ERT#��i �'V� ll �C? y„ 1 J ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,9$8,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing muntcipai system and arry house or building for which the
apptication is made,the owner or corrtractor shafi be required to obtain 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 Departmerit shall be notified. it shail be unlawful to cover
any connecting line until an irispection has been made and such connedion and the worlc incident thereto has been approved by the City as a
proper and suitabte connection.
402.06 REPAIRS AND MAINTEMANCE TO CONNECTION
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 kad has
been extended to the property line for connection,the applicant,owner,or occupant or user af such premises shail be liabie for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. Ff the property awner
requests mair�tenance seroice or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicarit,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main incfuding debris clearing 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 ofi the land or property. (Ref 638,1156,1191)