Meter Swap s
. Request Number: 12337
Public works Division
Service Request
Problem.4ddress: 7301 Jackson St Requested By: Charles Smith
Department: WATIIt Addresa: 7301 Jackson St
Fridley,MN 55432
Problero/Iasue: INSTALL AMR METER Phone Number: 763-784-2346
Sc6eduled Dnte: 2016-12-15 � ed ed Tlme: 10:30:00
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ACl'ION NEEDED:Install
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Created by: Beth Kon�ick Date Created: 2016-12-02
ACTTON TAKEN:
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Status: In Progess Snbmitter Has Been r,
Contuted
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Date Completed: Compteted by: ;' t'
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City of Fridley �/* � �, � �;
` Water Department �`
' 6431 University Avenue NE
Fridley, MN 55432 ��j -��]q�l� �►
763-572-3566
I/we hereby authorize the City of Fridley and/or its empioyees 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 interior
plumbing. (Per�ty code 402.06) 1 also hold the City 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,walis,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READiN6(old meter) � �C/
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Name:��Gu� �(,'S .o �1 1�\ Address 1 ��1 J�6� S
Phone Number ��1 � 2 J �0 Date l�f 1,� � �
� Signature C Witness Signature '�`��—��
OLD METER# t��� fr� J � �
OLD READiNG 1�[.--� �?o V
NEW METER# '�41 � '�L-(,�Z
NEW READtNG l J
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ERT# 4G����„�� I l )
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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 constructtng or repair of any water of sewer line wnnecting the existing municipai system a�d any house or butlding fo�which tlte
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 shall be notified. It shall be unlawful to cover
any connecting line untii an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connedion.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection 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 connection,the applicant,owner,or occupant or user of such premises shall be liable fo�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 shali 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 shalt 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 inciuding debris dearing or
root cutting and to maintain the water service curb stnp box for operabitity and at such height as wilt ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
'� `��."t�"?� �t'�i�S�.,-,
� �,�';�INSTALLATION
G.�� AUTOMATIC METER READER
FRIDLEY '
Address �c�.)1, c�W�,�66�
Name �J�IZ1.;�� �`��
Date�p�-�`r� o�
Old Meter Number � �
Old Meter Reading �
Replacement No. -
Repiacement Reading Q�
Repiacement Make
ERT#
Replacement ERT#
Remarks:
�?��, Signed: