Meter Swap � ��x � ��� .�"i.� ���� ��
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� Request Number: 12353
Public Works Division
Service Request
Problem Acldress: 1400 Jackson St Requested By: Donald Sivauich
Department: WATER Addrtss: No adckess�xovided
Problem/1�sue: IN5TALL AMR METER Phone Nnmber: 763-786•5035
Scheduled te: 2016-12-07 Scheduied'Is�ne: 10:30:00
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ACTION NEEDED:A1�IIt
Created by: Wendy Hi�t Date Cres�ed: 2016-12-03
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AG"IION TAKEN:
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Status: In Progress Submitter�Been �.,
Cont�ted
Date Compteted: Campleted by:
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City of Fridley
Water Department
6431 University.Avenue NE
._ Fridley,MN 55432
763-572-3566
�1We hereby authorize the City of Frfdley and/or its empioyees to do what is�ecessary to
replace the water meter. 1 understand that tfie property owner is liable for the water line from the main to the premise and ail irrterior
plumbing. (Per C'rty code�02.06) I aiso hold the City of Fridiey andf its empioyees harmless for any damages that may occur while doing this
operation. This to include,but not limited to va{ves,piping,wafls,ftoors or the curb stop boz and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
F{NAL METER READING(old meter) � `� Z � �O�
Name• ��`.�,�, � �1�a�,� A r � � O V v G�c5�� �J�
Pfione Num l 1�"� ��_—'V✓�Jp Z� 7� � � "
Signature � Witness Signatare �"'�
OLD METER# 1� �� � I i �
OLD READING � v�1 � �O
NEW METER# � �� `�
NEW READING �
ERT# VJ� l) � � V � � _ ,
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FRIDLEY 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 any house or building fp�which the
application is made,the owner or contredor shalt be required to obtain a permit for such connection,and shali 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 not�fled. It shall be unlawful to cover
as►y conneding line until an inspection has been made and such connection and the worlc incident thereto has been approved by ifie City as a
proper and suitable wnnection.
402.06 REPAIRS AND MAINi'ENANCE TO CONNECT{ON
After the initiai connectto�has been made to tfie water service curb stop box or the sewer lead at the property line or a water servic�Iead has
been extended to the property line for connection,the applicar�t,owner,or occupaM or user of wch premises shall be iiabie for all repairs
required to any water line ar►d sewer lines netessary for con�edion of the premises from the main to the premises. lf the property awner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and(or
repairs,including�ecessary street repairs at a rate set annua�ly by an administrative poliry. It shall be the�esponsibility of the appliant,
owner,occupant or user to perForm standard mainte�ance of the sewer service line from the premises to the main including debrls dearing or
root cutting and to maintain the water service a�rb stop box for operability and at such height as will ensure that it remains above the finished
grade of the fand or property. (Ref 638,1156,1191)