Meter Swap . ,
Request Number: 15525
Public Works Division
Service Request
_ _ _ _ _ _ ___
Problem Address: 166 Longfellow St Requested By: Sue
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 612-280-4909
Scheduled Date: 2017-OS-30 Scheduled'lime: 11:00:00
. �S � `r` �-
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-OS-23
ACTION TAI�N:
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Status: In Progress 5ubmitter Has Been r
Contacted
Date Completed: Completed by:
j ��g � 1-1 � �T�:��o�
, City of Fridley �jr � ✓' ��� �`� �
' Water Departranent /�
6431 tJniversity Avenue NE �V� �(��, C
Fridley,MN 55432
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763-572356fi
i/we fierehy authorize the�ty ofi Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the pro�oerty awner is liable for the water line from the main to the premise and all irrterior
plumbing. (Per�Lity code 402.06) t also hold the C'rty of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. in understand i am aiso required
to obtain a permit prior to any work,'rf necessary.
F9NAl METER 6tEAD{AtG(oid meter) V� �v��
Name: � `�t'_� Address__� �� ��'lVy�� '�
Phone Number �O �� o� L `O 1Date �� �/V^ , `
�Signat�g Witness Signature
OLD METER#_ ��� lJ ���
OLD READING �./ �`�" I V ��b
NEW METER# t���� Z�
NEW READINC; V
ERT# r ����� ��
FR{DLEY CITY CODE
CHAPTER 402.WA�'ER,STORNt WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Orsl No 113,464,565,566,624,638,662,922,988, 1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line conneding the existing municipal system and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permit for such connection,and shall pay a perrr�it fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shatl be usatawful to cover
any connecting tine unti!an inspection has been made and such connection and the wortc incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
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 service lead has
been extended to the prvperty line for connection,the applicant,owner,or occupant ar user of such premises shalt be liable for a0 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,the property owner shall be charged for the costs of the maintenartce 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)
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City of Fridley
Water Del�artment
Address 'l� p �O i 'e',,�W ��
Name � V e � � � t e
Date � " � ^ �v .
Old Meter Number / �
Old Meter Reading � � � O ��
Replacement No. 4 � � v �
Replacement Reading_�_
Replacement Make 1 �.�-q�r
Remarks: ` '� ��`'�
S ign�
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