Meter Swap �
Request Number: 15482
Public Works Division
Service Request
Problem Address: 7581 Lakeside Rd Requested By: Bee Vang
Department: WATER Addreas: No address provided
Problem/Iasue: INSTALL AMR ME1ER Phone Number: 651-367-9085
Scheduled Date: 201'7-OS-22 Schednled Tlme: 11:00:00
22�"m`
AeTION NEEDED:
Created by: Beth Kondrick Dste�'reated: 2017-OS-19
ACTION TAI�N:
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,��:
Status: In Progress � Sabmitter Has Been r.
Co�acted
Dxte Completed: Completed by:
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' 3�d - � I 3 �(� - 6�-
� City of Fridiey
Water Departrnent ��� �/���j�„
6431 University Avenue NE �rl ��
Fridiey, MN 55432
�r 763-572-3566
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t/we hereby authorize the City of Fridley and/or its emptoyees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liabie for the water line from the main to the premise and all intericr
plumbing. (Per City code 402.06) i atso hold the City of Fridiey and/its employees harmless for any damages that may oaur while doing this
operatidf�. This to indude,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand i am alw required
to obtain a permit prior to any work,if necessary.
FIPIAL METER READING(old meter) ��a� ���
Name: ��� �W Address ��'�����i`j�/ .
Phone Number �Y� � p�e �^�� \�
Signature_ �/ \ l— Witness Signature
�
OLD METER# ���'SIO�37
OLD READING D S a$I�Z�
NEW METER# �$� � �I gS
NEW READING C�
E�r#_ .`? lg �a7 �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER APID SANITARY SEWER
ADMINISTRATIOPI
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to cortstructing or repair of any water of sewer line connecting the existing municipai system and any house or buifding for which the
appiication is made,the owner or contrador shall be required to obtain a permit for such connection,and shati 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 witable connection.
402.06 REPAIRS APID MAINTENANCE TO COPINECTION
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 sero�e lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shali!�Ifable for a!!repatrs
required to any water line and sewer lines necessary for wnnection of the premises from the main to the premises. tf the property owner
requests maintenance senrice or repairs be performed by the C'ity,the property owner shail 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 shall be the responsibility af the appiicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
U3�c� ���1a-�
_ ��o,�
City of Fridley
Water Department `�
Address ��,.1 O� �°i!�-e 5)�e �
Name V`�y �a°�e"n
Date ���t r� `
Old Meter Number �� � ` ✓ o � �
Old Meter Reading d� � ��
Replacement No. ������ � �
Replacement Reading � _
Replacement Make ��-��'
ER'F-
_
, Replacement ERT#
Remarks: � L� � C
Signed �� -
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