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Meter swap . Request Number: 12345 Public Works Division Service Request Problem Address: 7350 Jackson St Reqaested By: Todd Zex� Department: WATER Address: 1350 J�kson St Fridley,MN 35432 Problemllssne: INSTALL AMR ME'IER �ho�Nwnber: 763-786-1499 5c��ed-p� Z016-12-16 C � Sclisdalsdllae: 1U:30:00 7 \ T` �`� �� ACII+Oi�NLED�'.D:instail AMit Crea�ed by: Bdth Ko�drick Hate�e#ed: 20i6-12-03 ACTIUN TA1�EN: � � 5tat�: �Progress �n�tter I�Iu Heen �, . Conhctad Date Cosple�ed: Completed by: Hours I Z_ � - � ' �� �_ � I 6 �-- City of Fridley � � � Water Department , �n 3 � • 6431 University Avenue NE Fridley,MN 55432 �j�C�-��I �j C1�v� 763-572-3566 1/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 ali interior plumbing. (Per City code 402.06) 1 aiso hold the City of Fridley and/its employees harmless for any damages that may oaur while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required to obtain a permit prior to any work,if necessary. FINAL METER EADIPIG(ofd meter) +� 1� � �" Name�� � w�` C�- Address�����,�����h �� Phone Number 4����������� Date � �� � � �� � � Signature�� Witness Signature �_ OLD METER# t}������„�I OLD READING v� �� � ✓V NEW METER# ���,�� �� NEW READING V ERT# �(cl +����� `� 1 FRIOLEY CITY CODE CHAPTER A02.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 Iwi{dirrg for which the application 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 shal!be notified. it shall be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION Aher the initiaf connection has been made to the water service curb 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 applicant,owner,or occupant or user of 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 properry owner shait be charged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall he the respansibility of the applicant, owner,occupant or user to perform sta�dard maintenance of the sewer service line from the premises to the main including debris clearing or root tutting and to maintain the water service curb stop box for operability and at such height as wili e�sure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)