Meter Swap , Request Number: 12726
Public Works Division
Service Request
Pro�em Addreas: 7340 Jackson St Requested By: Desiree Stark
De�artment: WA'IFR Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-462-0976
Scheduled Dtt : 017-01-06 Sc�edrled 11e�e: 08:30:00
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ACIION NEEDED:
G�eated by: Wendy Hiatt l�te Cre�ed: 2017-01-04
A(.'1ION TAI�N: �
1 Y��-�c�1� �c�`,
5tat�: In Progress Snbmitter Has Beea �,
Contacted
DKe Compltted• Completed by: -�
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Cit�t of Fridley
Water Department
6431 University Avenue NE ����_�I��J v�--
• ` Fridiey,MN 55432 � � � � � �
' 763-572-3566
�/We hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. I understand that the property owner is liable tor the water line from the main to the premise and al!iMerior
piumbing. [Per City code 402.06) i aiso hold the City of Fridley andJits employees harmiess for any damages that may occur while doing this
operation. Tfiis to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior ta any work,if necessary.
FINAL METER READIN6(old meter) �✓ --
Name: ``� Address L�—Yl' �f�!��� �
Phone r ��� `b�"���O pate �� y`''f Y 1
Sign I Witness Signature
OLD METER# � ��� ��
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OLD READING " 4�� 1���lJ
NEW METER# ������ 4�
NEW READiNG v
Errr# ���U� b��V �
FRIDLEY CITY COOE
CHAPTER 402.WATER,STORM WATER ANO SANlTARY SEWER
ADMINISTRATIOAI
(Ref Ord No 113,464,565,566,629,G38,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to construding or repair of any wate�of sewer line connecting tF�e exlsting municipai system and arry house or buildir�for which the
appiication is made,the owner or coMractor shall 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 Department shall be notified. it shail be unla�aful to cover
any connecting line until an inspection fias been made and such connection and the work incideM thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAiRS AND MAINTENANCE TO CONNECI'ION
After the initiai connection has been made to the water service wrb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for connection,the applicarrt,owner,or occupant or user af such premues sball be liable for all repairs
required to any water fine and sewer tines necessary tar connection af the premises from the main to the premises. If d�e property owner
requests mairrtena�ce senrice or repairs be perFormed by the City,the property owner shali be charged for the costs of the mairrtenance andJor
repairs,including necessary street repairs at a rate set annually by an administratiVe policy. It shaN be the responsibifity of the applicarrt,
owner,oauparrt or user to perform standard maintenance of the sewer service li�e from the premises to the main including debris deari�or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains a6ove the finished
grade of the land or property. (Ref 638,1156,1191J