Meter Swap Request Number: 16525
. Public Works Division
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Service Req�st
Problem Address: 7635 Meadowmoor Dr Requested By: Robert
Department: WATER Address: No address p�ovid�ed
Problem/Issue: INSTALL AMR METER Phone Number: 763-784-6409
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Scheduled Ds�te: 17-08-01 Scheduled 1lme: 08:00:00
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AC'ITON NEEDED:
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Created by: Wendy Hiatt Date CreAted: 2017-08-01
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ACTION TAI�Nr
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Status: In Progress Submitter Has Been r,
Contacted
Date Completed: Coa�pleted by:
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�6��£Fraei9ey ``� ( � � `7 (7� b� '" ��
iA��ter�epartmea�t � �, � � 1 �
f431 l7niversity Avenue NE 5
Fridley,MIV 55432
� 753-572-3566
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I/we hereby authorize the C'ity of Fridley artd/or its employees to do what is necessary to
replace the water meter. !understand that the property owner is liable for the water line from tfie main to#he premise and all interior
plumbing. (Per C�ty code 402.a6) 6 also hold the C�ty of Fridley andrts employees harmless#or arry dama�es that may occur while doing this
opera�tion. This to include,but not limified to valves,pipin�walis,floors or the curb stop baK and sesvice line. in understand i am also require
to obtain a permit prior to any work,if necessary.
FIPIAL METER READtRlG(otd meter} I ���� ���
Name• Address __�1E3�� �C�CJw/�(,'b�
Pho�e Num6er p�, —t 1 ��
Signature � °�.�
Witness Signafiure
OLD METER# _ � ! �•�Q���
OLD REAQtNG � � !C�'���
NEIA/METER#_ �/ 1��S �v��
NEW READIMG �
ERT#_�� � ��U
FRIDLEY CITY CODE
CHAPTER 402.WATER,Si'ORM WATER AND SANITARY SEWER
ADMINlSTRAT{ON
(Itef Ord No 113,454,565,566,629,638,662,922,988,1144,1156,119Ij
402.5 PERMlT FEE
Prior to sonstructing ar repair of any water of sewer line connecting the existing municipai system and arry house or building for which tl�e
application is made,the oavner or cor�tractor shali be required to obtain a permit for such connection,and shatt pay a permit fee as provided in
Chapter il of this Code. After such cannection has been made,the Water and Sewer Departmerrt shalt 6e notified. It shall be untawful to coveo
any connecting line until an inspection has been made and such conrtection and the wor[c inciderrt thereto has been approved by tlte City as a
proper and suitab(e connection.
402.06 REPAtRS AiVD MAINTENANCE TO COPfNECT10N
After the initial connection has 6een made to the water senrice curb stop box or the sewer lead at the property line or a arater service iead has
been emended to fihe property line for connection,the applicar�t,awner,ar occuparit ar user of such premises shalt be liable for al!repairs
required to any water line and sewer lines necessary#or connection of the premises from the main to the premises. ff the property oarner
requests maintenance service or repairs be performed by the�ty,the property owner shali be charged for the costs of the mairrtenance and/ar
repairs,including necessary street repairs at a rate set annually by an administrative policy. it shall be the responsibility of the appiicant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main inctuding debris clearing or
root cutting and to mairrtain the+arater service curb stop box for operability and at such height as wiil ensure that it remairr�above the finished
grade of the land or property. (Ref 638,1156,1191)