Meter Swap Request Number: 15897
� Public works Division
Service Request
Problem Address: 670 Janesville St Requested By:
Department: WATER Address: No address provided
Problem/Lssue: INSTALI.AMR METER Phone Number: 763-786-3016
SchedWed Date: Sc6ednled 13me:
2`r` g'.�
ACTION NEEDED: .
Created by: Wendy Hiatt Date Created: 2017-06-09
ACTION TAI�N:
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� Snbmitter Hns Been
tatus:
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� Co�acted
Date Compteted: (�— '� � �"� Completed by: �a1,.p
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Water Depaxtna�n�
, �439.l�niversity Aarencae IVE � � //.���
. Fetidley,MN 55432 �f
763-572-3566
'�1Ye hereby authorize the Gty of Fridley and/or its empioyees to do what is necessary ta
replace the water meter. 1 understand that the�roperty owner is liabfe for the water line from the main to the premise and aH inte�ior
plumbing. (Per�rty code 402.06j I elso hold the Cit3/of Fridley andrts empioyees hamntess for any damages that snay occur while doing this
operation. This io indude,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand t am also require
to abtain e permit prior to any work,�f necessary.
FINA!MEfER READIP{G(old meter) `� ` v " � V�
Name: Address _��v �J C�(/►�j 1)��i11e J�.
Phone Number �3 '"� �Q�' J��� p�e � — 'Z ` l�
�nature Witness Sigrrature
OLD METER# � ( � � �� � �
O!D READING v ��� ��v
NEW METER# � l�0'� � U��,
NEW READlNG �
��,-# -1�.3� 5 b dS
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORNI 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 iine connecting the existing municipal system and any house or building fo�which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and s6a(1 pay a permit fee as provided in
Chapter 11 of ghis Code. After such connection has been made,the Water and Sewer Departmer�t shail be notified. It shalt be unlawful to cover
any connecting tine unti!an inspection has been made and such connedion and the wor(c incident#�ereto has been approved by the Crty as a
proper and suitable connection.
4A2.06 REPAIRS AND MAINTEIVANCE TO COPINECTION
After the initial,connection has been made to the water seroice curb stop box or the sewer fead at the property line or a water service tead has
been axtended to the property line for tonnect�on,the appficant,oarner,or occupar�t ar user of such premises shall be liable for ail repairs
required to any vorater line and sewer(ines necessary for connection of the premises from the main to the premises. ff the property oarner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the maintenartce and/ar
repairs,inctuding necessary street repairs at a rate set annuaily by an administrative policy. It shaU be the responsibitity of the applicant,
owner,occupant or user to perform standard mairrtenance of the sewer senrice line from the premises to the main includin�debris dea�ng or
root cutting and to mair►tain the s�vater service cerrb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1155,1191)