Meter Swap : Request Number: 15568
y
Public Works Division
Service Request
Problem Address: 270 Liberty St Requested By: John Rejman
Department: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-785-1489
Scheduled Date: 2017-06-1 Scheduled Time: 10:00:00
� ��
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-OS-25
ACT[ON TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
�City of Fridley �1 U - 5� 3"l�n �0�
Water Departrv�ent �
� 6431 lJniversity Avenue NE �n��(� �
�v �,.� !
' Fridley, MN 55432
763-572-3566
�
��'"�e � �' `� u`� hereby authorize the C"�ty a#Fridley and/or its emptoyees to do what is necessary to
replace Che water meter. i un rstand that the property owner is liable for the water line from the main to the premise and all interior
piumbing. (Per Crty code 402.06) 1 alsa hold the City of Fridiey and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not{imited to vatves,piping,wails,floors or the curb stop box and service line. in understand i am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READ{NG(old meter} � ` � J����
Name: ti � Address ��0� .L�('T t �,� , tv. ` ^ f�YJ
,� S
:��� � - -, , � ;���1 � ��r���-
Pho�e Number , �, Date
� ` �
Signature ! ' � i Witness Signature
OLDMETER# �������-� I�
`(.
OLD READING ����� �C�
NEW METER# __ �� ��,�,,��/,� l.I
NEW READING C%
�-'1 C�
E�tT# � � 3 � � � �
FRIDLEY CITY COQE
CHAPTER 402.WATER,STORiVt WATER AND SANITARY SEWER
ADMINISTRATION
(IZe#Orsl 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{ine connecting the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtein a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shalt be natified. It shal{be untawful to 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 MAINTENAIVCE TO COIVNECTION
After the initial connection has been made ta the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for sonnection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary#or connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the City,khe property owner shall be charged for the costs af the maintenance and/or
repairs.including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service tine from the premises to the main inciuding 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 af the land or property. (Ref 638,1156,1191)