Meter Swap ' Request Number: 12413
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PU�1C wOTk3 DIVIS10Il
Seivice Request
Problem Address: 7698 Jaekson St Requested By: Kay Philbrook
Depsrtment: WA1ER Address: No address pcovided
Problem/Isat�: INSTALL AMR METER Phone Number: 763-785•9'I89
Scheduled Date: 2016-1 - 5 Schedaled 1�me: 08:30:OE)
, � ��, �
ACTTON NEEDED:AMIt
Created by: Wendy Hi�t D�te Created: 2016-12-09
ACIION TAI�N:
______._..'JC�_ �� �
a� ,
St�tus: In Progcess Submittcr Has Been r.
Contacted
Date Completed: Completed by:
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City of Fridley �� ` f� � �j
Water Department � �r �
6431 University.Avenue NE
. , ' Fridley, MN 55432 ��,�'����13v..{��.
763-572-3566
�IWe hereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City wde 402.06) t aiso hold the C"ity of Fridiey and/its employees harmless for any damages that may occur 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 t am also required
to obtain a permit prior ta any work,if necessary.
FINAL METER READtNG(old meter) �� � �� � �
Name:�GL� 1 V�+I p Ct7C�� Addreu �Co�L� �0�1�Oh J�
Phone Number l�n J'� ��_�7D� Date ` !�' ` �J'r ��
� Signature '�'����LJI�-�-� Witness Signature �---��
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OLD METER# � V-t Ci �� ��o
OLD READING �"6 �� "t ��
NEW METER# �L 1 �; � �� � '
NEW READING _ lJ
ERT# 10�� I t �S�
FRIDLEY CtTY 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 repatr of any water of sewer line connecting the existing municipai system and arry house or building for which the
appiication is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shali pay a permtt fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be nW�fied. 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 Ctty as a
proper and suitabie wnnection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC770N
After the initial connection has been made to the water service curb stop box or the sewer lead at th�properry line or a water senrice lead has
been extended to the property line for connection,the appilcant,owner,or occupar�t or user of such premises shall be liable for a!I 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 mairrtenance service or repairs be performed by the C7ty,the property owner shall be charged for the costs of the mairrtenance and/or
repairs,including�ecessary street repairs at a rate set annuaily by an administrative poliry. R shall be the responsibility of the appliprrt,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land os property. (Ref 638,1156,1191)