Meter Swap - ' Request Number: 13024
Public Works Division
Service Request
Problem Address: 7570 Lakeside Rd Reqnested By: John M.
Department: WA'IER Addreas: No address provi�ed
Problem/Iasue: INSTALL AMR METER Phone Nnmber: 612-327-2873
Sehednled Date: 2017-02-25 Scheduled 1lme: 07:00:00
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ACIION NEEDED:
Created by: We�y Hi�t Date Crested: 2017-01-23
ACTION TAI�.N:
YW� , _vy ����
St�tns: In Progress �alimitter Has Beea r,
Co�acted
Date C�mpieted: Completed by:
Hoars ` �
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iNateo-Departat�ertt
6431 i7niversity Avenue NE
Fridley, MN 55432
_ 763-572-3565
9/we hereby authorize the Ciiy af Fridley and/or its employees to sJo what is necessary to
replace the water meter. !understand that�he property owner�s liable for the water line#rom the main to the premise and all interior
plumbing. (Per City code 402.�) i a(so hold the City of Fridley andJFts employees harmiess#or eny damages ifiat may occur while doing this
operation. This to include,!wt not lim�#ed to valves,piping,walls,floors or#he curb stop box and servece line. In understand!am also require�
to obtain a permit prior to any wo�9c,if necessary.
3ro - 5/ 33 � v - o2�.
FlNAL METER READING(oki meter) � — ` �� � � Jv� ��O �
Name:�,1,�� Address ���O �"—'"�'���-
Phone Numbe � V �� /rJ p� �j'" v�r �,�
Signature Witness Signature
OCD METER#_ O ` � I � Z � l
OLD READING ��2� � � �
NEW METER# i�a� / � `
r1EW READING �
ERT# ���1 Y- f' F "'1
FRIDLEY�ITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,I144,1156,1191)
402.5 PER9IAIT FEE
Prior to constructing or repair of any wate�ofi sewer line connecting the existing muniapai system and arry house or bu7ding for which the
application is made,the owner or cor�tractor shait be required to obtain a permit for such connection,and shaU pay a permit fee as provided in
Chapter 11 of this Code. A#ter such connection has been made,the Water and Sewer Department shali be not�ed. It s(�all be un(awful to cover
any connecting line until an irispection has been made and such connection and the worlc inciderrt thereto has been approved by the City as a
proper and suitable connection.
402.05 REPAtRS AAtD MAINTENAMCE TO CONNECTION
After the initiai connection has been made to the water senrice arb stop box or the sewer lead at the property iine or a water service lead(ws
been extended#o the property fine for connection,the appiicant,owner,or accupant or user of wch premises shall be IiaWe for�II repairs
required to any waCer line and sewer lines necessary for+connection of the premises from the mai�to the premises. If the property owner
requests maintenance service or repairs be perFormed by the Crty,ihe proper�ty owner shatl be charged for#he costs aF the mairrtemance and/or
repairs,including�ecessary street repairs at a rate set annuaily Iry an administrative policy. It shali be the responsibility of the applicarrt,
owner,occuparrt or user to pe�form standard mairrtenance af the sewer service line from the premises to the main including debris dearing or
root cutting and to mairrtain#he water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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