Meter Swap y � Request Number: 12437
Public works Division
Service Request
Problem Addreas: 7498 Jackson St Requested By: Kim Rila�d
Depxrtment: WATER Addresa: '1q98 3ackson St
Fridley,MN 55432
Problem/Issue: INSTALL AMR ME1ER Phone Nnmber: 612-245-1293
Scheduled Dxte: 2016-12-19 Sc6edaled'I1me: 10:0(1:00
�U � � �
AG'IION NEEDED:Iustatl AMR
Created by: Beth Ko�drick Date Cre�ed: 2016-12-13
ACTION TAI�N:
���ti� � � '
- �
Statas: In Progess Snbmitter Has Been �
Cont�ted
Date Completcd: Completed by: £, , /�, ��-
/ �� d1�
I�- -- I 1 _ I ,/ ,�
City of Fridley ��, � � �-�
Water Department
. 6431 University Avenue NE -���� ,�'��� �p.�p�
. Fridley, MN 55432
763-572-3566
�/M+e hereby authorize the City of Fridiey and/or its ernployees to do what is necessary to
replace the water meter. 1 understand that the property owner is liabie for the water line from the main to the premise and aii irrterior
plumbing. (Per City wde 402.06� i also hold the�ty of Fridley and/its employees harmiess for any damages that may occur while doing this
operation. This to include,but not limited to vaives,piping,wails,floors or the curb stop box and service line. fn understand f am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READtNG(old meter) � " � ��
Name• F.�� � � ` V"� Address ��[ 1 �J �G�� C�'r �
• ,ri,
Phone Number; � � — Date �� �r ``"1� �
XSignat Witness Signature " �---------`_
OLD METER# �Jl� � r� � � , .
OLD READING �� � ����
NEW METER# I 1 V I l..�%��
NEW READING �
ERT# � /J � ' �
FRIDIEY 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 ar�y house or building fo�whlch the
appiication is made,the owner or corrtractor shall be required to obtain a permit for such connectlon,and shall pay a permft fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notifled. It shall be uniawful to c�ver
any cannecting line untif an inspection has been made and such connettion and the work incldent thereto has been approved by the City as a
proper and witable connection.
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 iine or a water service kad has
been extended to the property line for connection,the appiicant,owner,or occuparit or user of such premises shali be 1'�aWe for all repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the property owner
requests mair�tenance service or repairs be performed by the Gty,the property owner shail be charged for the�of the rtiai�enance and/or
repairs�includi�g necessary strest repairs at a rate set annuaNy by an administrative pofiry. li shail be the responsibility of the applipM,
owner,occuparrt or user to perform standard maintenance of the sewer senrice{ine from the premises to the main includirig debris ciearing or
root cutting and to mairrtain the water service curb stop box for operability and at such height as wiil ensure that it remains abrnre the finished
grade of the land or property. (Ref 638,1156,1191)