Meter Swap �� �- , c �- ���--.._._.�
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Request Number: 12311
Public Works Division
Service Request
Problem Address: 73?1 Jackson Street Requested By: Richard Maras
Department: WATER Address: 7371 Jackson Street NE
, Fridley,MN 55432
Problem/Issue: INSTALL AMR METER Phone Number: 763-786-5860
Scheduled Date: 2016-12-02 Schednled Tlme: 08:00:00
ACTION NEEDED:Install AMR
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Created by: Beth Kondrick Date Created: 2016-12-01
ACITON TAKEN:
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Status: In Progress Submitter Has Been �
Contacted
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Date Com eted: �2. a H Com leted by: �
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City of Fridiey ��� _S--T�y� vt
Water Department �
6431 University Avenue NE
Fridley, MN. 55432 � � � / � �
763-572-3566 «�
Ijwe 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 atl interior
piumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages thai rnay occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand f am also required
to obtain a permit prior to any work,if necessary.
FITIAL METER READING(old meter) ��`��1� �'1
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Name:���1� � �� Address �J� � ��kson
Phone Num4a � ��s ^ ������'�� Date �� i �XJ
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Signature Witness Signature
OLD METER# ��
OL�READfNG C� �t� �) O
NEWMETER# "l�l`U��1"�
NEW READING �
ERT# �,��� , ��q
FRfDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMIN{STRATION
(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 arry water of sewer tine connecting the existing municipal system and any house or building for which the
applitation is made,the owner or contractor 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 unlawful to cover
any connecting line untii an inspection has been made and such connection a�d the work incident thereto has been approved by tfie City as a
proper and suitable connection.
402.06 REPAIRS QND MAiNTENANCE TO COMNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a wate�servioe lead has
been extended to the property line for connection,the applicant,owner,or occupaet or user ot such premises shall be liable for 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 owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shait be the responsibility of the appiicarit,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to tbe main including debris dearing or
root cutting and to maintain the water serv�ce curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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City of Fridley
Wat_epartment
Address / � 7/ � � u/`'i✓�`"�
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Name �/��'l"G�c�/r t"��'�d S
Date �/.- °� `�
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Old Meter Number � `�3�Z�� f
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Old Meter Reading _
Replacement No. L�2 � � �`�
Replacement Reading �
Replacement Make ��/��'°�
Remarks: � � �`�'`�
Signed
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