Meter Swap � A Request Number: 15538
Public Works Division
Service Request
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Problem Address: 170 Liberty St Requested By: Peggy Brown
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-780-1375
Scheduled Da : 2017-OS-26 ,� Schednled Time: 07:00:00
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ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2017-OS-24
, ACTION TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: � —a�.�� `� Completed by: '
C1`��.
�ity of Fridley
�t� � 5l� ��o a�
� Water Department
, 6431 lJniversitYAvenue NE S� � (.,� �Z�
Fridley, MN 55432
763-572-356�
��'Afe hereby autfiorize the City of Fridley and/or its emptoyees to do what is necessary to
replace the water meter. t understand that the property owner is liab(e for the water line from the main to the premise and all irrterior
pfumbing. (Per City code 402.06) l also hold the City of Fridiey and/its employees harm4ess for any damages tfiat may accur while doing this
operation. This to include,but not limited to vatves,piping,walis,#loors or the curb stop box and service tine. !n understand i am also required
to obtain a permit prior to arry work,if necessary.
FINAL METER READING{o1d meterj `-� 1 �� ` � V
Name° �� ����1 Address � I � 1.,i�J�-r �Y ���
Phone lVumber 1� 3 �����'" l✓�� Date �� v` �.Q '-" � �
i�Sig,nature �� Wetness Signature �-
OLD METER# ✓�� � � ���
OLD READING � ` �� ���
NEW METER# � 1�C� l6� �3 I
NEW READlNG V
E�T# `�� 3 � 5 ► c� �;
FRIDLEY CIT!CODE
CHAPTER 402.WATER,ST�RM WATER AND SANITARY SEWER
ADMtNISTRATfON
(Ref Ord No 113,464,565,556,629,638,662,922,988, 1144, 1156,1191)
402.5 PER11f{IT FEE
Prior to constructing or repair of any water of sewer line con�ecting the existing municipal system and any house or bui(ding for which the
application is made,the owner or contractor shall be required to obtain a persnit for such conneetion,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such canc+ection has been made,che Water and Sewe�Department shall be notified. ft shall 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 CONNECTIOAI
After the initial conneccion k�as been made to the water secvice curb stop box or the sewer lead at the property line or a water service iead has
been extended to the property line fior sonnection,the app(icant,owner,or occuparrc ar user of such premises shall he liable for all repairs
required to any water line and sewer{ines necessary#or connection of the premises from tfie main to the premises. Ifi the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for tMe costs of the maintenance andJor
repairs,including necessary street repairs at a rate set annuaNy by an administrative poliry. !t shall be the responsibility of the applicarrt,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main intludi�g lebris clearing or
root cutting and to maintain the wvater 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 638,1155,1191}
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�'�` ` ��,�w �� FridYa� t ��: K rt��.
, ����r De�art��nt
Address �,�� �� �-e r �y �f
Name �C � I'�� Lv 11
Date �: 3 4 'O�
Old Meter Number � 3�' � ���
Old Meter Reading � � 3 O
Replacement No. 3 Q � O� ��
Replacement Reading �
Replacemer�t Make �� Q.-�-°�G;'
Remarks: �� �
Signe
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