Meter Swap ,
� Request Number: 15691
Public Works Division
Service Request
Problem Address: 281 Longfellow St Requested By: Beverly
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number: 763-780-2780
Schedoled Date: 2017-OC�-OS 5cheduled Time: 07:30:00
�f1�u�n ` u. S�` �7:3a
ACTION NEEDED:
Created by: Beth Kondrick Date Created: 2017-06-01
ACTTON TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
� ^�� `� � �"�
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�ity o���aiey 2 �I _ Cj,��7jd -0 2
water Departro,ent ✓ � � IL� (�
; 6431 l�niversity A�renue 1VE K `� �
' Fr6dley, MN 55432
763-572-3566
i/we hereby�uthorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 a�nderstand that the�roperty mwner is liabte for the water 9ine from the anain to the premise and all 9rrter6or
plumbing. (Per£ity code 402.06) I also hold the Cifiy of Fridtey and/its employees harmless for any damages that may occur whiie doing this
operatiom. This to include,but not lim'rted to valves,piping,walls,floors or the surb stop boK and service line. In understand 1 am also requirc
to obtain a permit preor to any work,if necessary.
F9NA!METER READIIYG{old meter) � r�� � �
Name: Address ��� �'Cvl� �
Phone�lumb �� l/�� Date � �r 1�
V:'Signature 111litness Signature
N
Ol.D NIETER# ��VZ v I �,J
OLD READ9NG � ( Z� � ��
1��1t1/NIETER# � `�� ��� 1
PIEM/READING V
E�-�# � �22��y��
FRIDLEY CIT`f CODE
CF�APTEl3 402.WA�ER,ST'ORN!WATER AND SANITARY SEWER
ADMINBS�'RATION
(Ref Ord No 113,464,56 a,566,529,538, 662,922,988, 1144, 1156,1191j
402.5 PERflA1T FEE
Prior to cvnstructing�r repair of any water of sewer line connecting�he existing municipal system and any house or buitding for which the
application is made,the owner or contractor shatl be required to obtain a permit�or such con�ection,and shall pay a permit fee as provided in
Chapter 11 of Yhis�ode. After such connection has 6een made,the Water and Sewer Department shali be notified. It shall be unlawful to cover
any connecting line until an inspeckion 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 MAINTENANCE TO CO{VNECTIOiV
After the initiat connection has been made to the water sen�ice curb stop box or the sewer lead at the property line or a water service lead has
been eutended to the p�operty line for connection,the applicant,owner,or occupant o�user of such premises shall be liable for all repairs
required to any water line and sewer tines 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 shali be charged for the costs af the maintenartce and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. It shail be the responsibility of#he applicant,
owner,occupant or user to perform standard rnaintenance of the sewer service line from the premises to the main including debris clearing or
root�utting 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 638,1156,1191j