Meter Swap , Request Number: 12498
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Public works Division
Service Request
Problem Address: 7321 Jackson St Requested By: Mary Rose Hegla�d
Department: WATER Addres:: 7321 Jackson St
Fridley,MN 55432
ProWem/Iaaue: INSTAL,L AMR METER Pho�Nnmbers
Sc6eduled Date: 017-01-03 Schedrled 1ime: 02:00:00
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ACIION NEEDED:Tnstatl AMR
Created by: Beth Kondrick IMte Cre�ted: 201b-12-i 6
ACTION TAI�N:
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Status: In Progress Sub�itE�r Haa Been �
Cont�ted
Date Compieted: Complettd by;
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City of Fridley ,�� ` ���
Water Department
6431 University Avenue NE ��, �--����U-��
' Fridley,MN 55432
' 763-572-3566
�/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 ail irrterior
plumbing. (Per Ciry code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operatian. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any wortc,if necessary.
FINAL METER READING(old meter) �� � � � ��
Name:� Acldress �
Phone Number �"' Date ��"`� �
Signature Witness Signature
OLD METER# � � �� L�J��
OLD READING ��- \ � � �JD
NEW METER#���� E.����
NEW READING �
ERT# � �
�RIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house or building for whid�the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shal!pay a perm�fee as prov{ded in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shaii be unlawful to cover
any connecting line until an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the wate�service curb stop box or the sewer lead at the property Itne or a water senri�lead has
been extended to the property line for connedion,the appiicant,owner,or occupant or user of such premises shall be IiaWe fa�all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property a�rner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the maintenance and/or
repairs,includin�necessary street repairs at a rate set annuaNy by an administrative poliry. R shail be the responsibility of the applicant,
owner,occupant 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 maiatain the water service curb stop box for operability and at such height as wiii ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)