Meter Swap �
,
Request Number: 16206
Public Works Division
Service Request
Problem Address: 612 Lafayette St Requested By: LouAnn
Depnrtment: WA1ER A,ddress: No address�ovided
Problem/Issue: INSTALL AMR METER Phone Number: 612-275-5737
Scheduled Date: 2017-06-3 Sc6eduled'lyme: 0830:00
✓ ' � �O� �:�O
ACTTON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-06-29
ACTION TAI�N:
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Submitter Has Been ��
Status: In Progress Contacted r
Date Completed: � -^ 3 v-- ,� Completed by:����
� � �� �- �i3 � `�a �"�?�-
� �ity of Fridley
Water Department �� � ��� Z
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
��`"�e hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the main to the premise and ail interior
piumbing. (Per City code 402.06) I also hold the City of Fridley andPts employees harmless for arry damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and senrice line. in understand!am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj ���� lJ� v
Name• �V� � Address �'" 1� ��G� "'e'��'�'e ��~
Phone Number t,J�l !��� t�"' -J�� p� � — 3(�` ��
� ��
� Signat e ; � Witness Signature
OLD METER#_ I�v ��g��
OLD READING �� � 1 lSj V
NEW METER# �� � ��✓ � v y
NEW READING v
ERT# ��- 1� ����
FRIDLEY CITY CODE
CHAATER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Plo 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 any house or building for arhich the
applica#ion is made,the owner or contractor shall be required to obtain a permit for such conoection,and shail pay a permit fee as provided in
Chapter li of this Code. After such connection has been made,the Water and Sewer Departmerrt shalt be notified. It shail be unlawful#o cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAIPITENANCE TO CONNECTION
After the initiai connectio�has been►nade to the water service curb stop box or the sewer lead at the property Iine or a water�rvice iead has
been extended to the property line for connection,the app(ipnt,owner,or occupant or user of wch premises shall be liable for all repairs
required to any water line and sewer lines necessary for connection af the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of ihe mairrtenance and/ar
repairs,including necessary street repairs at a rate set annualfy by an admirtistrative policy. It shaU be the responsibility af the applicarrt,
owner,occupant or user to perform standard mairrtenance 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 wch height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)