Meter Swap - Request Number: 12571
Public Works Division
Service Request
ProWem Address: 764�Jackson St Requested By: Sharon Kopesky
DepsrtmeM• WATER Addreas: 7647 3acicson St
Fri�ey,MN 55433
ProMem/Issue: INSTALL AMR METER Piane Number. 612-991-2527
Sc6e�ded 2017 O1•04 Schedrledllme: 08:30:00
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ACIION NEEDEDt Ic�tall AMR
Created by: BEth Kondrick Date Cre�ed: 2016-12-27
ACTION T
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�us: 1n Pro�ress 5�b�itter Has Been r
Contscted
Date Completed: Completed by:
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City of Fridley
Water Department
6431 University Auenue NE �
> Fridley, MN 5543Z �����/������i
, 763-572-3566 �� j �Z �
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1/we hereby authorize the City af 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 iMerior
plumbing. (Per City code 402.06j t atso hold the C'�ty 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 box and service line. lo understand 1 am also required
to obtain a permit priar to any work,if necessary.
FINAL ME'fER READING(old meter) � � �" �� �
Name: �'�� Address� ��� ����s�� ��
Phone Number ���i t 1 �`^ i-cJ� Date ��� ��
�Signature Witness Signature
�lD METER# -1 � ` }�� �
OLD READING ZS �� 2-��
NEW METER# �� 41��0 1
NEW READ{NG �
ERT# �� �� � � �
FRIDLEY CiTY CODE
CHAPTER 4U2.WATER,STORM WATER AND SANITARY SEWER
ADMiNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,115fi,1191)
402.5 PERMIT FEE
Prior to constructing ar repair of any water of sewer iine connecting the ezisting municipal system and ac�y fia,�se or buiiding for whid�the
application is made,the owner or coMractor sha{I be required to obtain a permit for such connection,and shali pay a permit fee as p�rnrided irr
Chapter 11 of this Code. After such connection has been made,the Wate�and Sewer Departmer�t shalf be notified. It shail be unlawful to cover
any connecti�g line until an inspection has been made and such connection a�d the work irlcident thereto has been approved by the C'ity as a
proper and suitabie connection.
402.06 REPAlRS AND MAfNTENANCE TO CONNECTION
After tfie initial connectlon 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 acwpaM or user of such premises shall be tiabie for ai)repairs
required to any water line and sewer lines�ecessary for connection of the premises firom the main to the premises. If the properly auner
repuests mairrtenance service or repairs be performed by the City,the property owner shall be charged for the cosis of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually bY an administrative poiky. It shail be the responsibifity af the appiicant,
owner,accupant or user to perform standard mairrtenance af the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)