Meter Swap � City of Fridley � � "� l ��3
- Water Department
6431 University.Avenue NE � I � ^�-��,3� ���..
Fridley,MN 55432
763-572-3566
I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City code 402.06) I also hold ihe City 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 also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � �� � � � D
Name: Address ��� [� � `Gi�Vl1 �� �
`� r ` �'J
Phone Number Date r ^ L7 O 1
_....__
Signature Witness Signature
���7�v � �
OlD METER#
OLD READING � � � � ` � � 1�'
2 � G�
NEW METER# ���C�� � �,��
�,) M"'
NEW READING ���
E�# �1 �� i2.���-1 �
FRIDIEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATtON
(Ref Ord 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 line connecting the existing municipal system and ar�y house or building for which the
application is made,the owner or wrrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be�ot"�f'ied. It shaii be unlawful to cover
any connecting line until an inspection has been made and wch connection and the worlc incident thereto has been approved by the City as a
proper and suitable connection.
. a
402.06 REPAIRS AND MAINTENANCE TO CONNECTION '
After the initiai 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 property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water line and sewer li�es necessary for connection of the premises from the main to the premises. If the properly owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. R shall be the responsibility of the appikant,
owner,occupant or user to perForm standard mairrtenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operabitity and at such height as wFli ensare that it remains above the ftnished
grede of the land or properly. (Ref 638,1156,1191)
r
.
� � Request Number: 12949
. �-
Public Wo�s Division
Service Request
Problem Address: 1362 Meadowmoor Dr Requested By: Mary
Department: WATER Addres:: 1362 Mesdowsnoor Dr
Fridley,MN 55432
Problem/L�aue: INSTALL AMR ME1ER P�o�Nwnber: 763-331-0623
Schednled Date: 2017-02-10 Schedaled 11me: Ol:30:00
AC'IION NEEDED:Iffitatl AMR
Cratted br: Beth Kon�ick D�te Cre�ed: 201�-01-19
ACTiON TAi�N:
Status: In Progress ��tter Hs Beee r,
Contacted
Date Completed: Completed by:
Hours
Wate�-�e�arta�rtent
�
5431 iDniversity J�venue P1E
.
Fridley,MN 55432
763-572-3566
. !/we here6y authorize the City af fridley and/or its empioyees to slo what is necessary to
re�9ace+the wafier meter. f understand that the property owner is liabie for the water line from the main to the premise and all interior
plumbing. (Per C'ity code 402.06j i aiso hold the C'�ty of Fridley and/'rts employees harmless for any slamages that may occur while doirtg this
operation. This to incfude,but not Cm'rted to valves,piping,wails,floors or the curb stop boz and service line. In understand!am also require�
to obtain a permit prior to arry avo�#c,if aecessary.
FtNAI METER READING(old mefier)
tVame• Address
Phone Number p�
Signature Witness Signature
OLD METER#
OLD READt1�IG
NEW METER#
NEW READING
ERT#
FRiDLEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Qrd No 113,464,565,566,529,638,662,922,9$8,1144,i156,1191j
402.5 PERMfT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipai system and arry house or building fo�which the
application is made,the owner or wrrb actor shatl be required to abtain a perm+t fos such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Department shali be not'rf"ied. It shall be untawful to cover
arry connecting 6ne until an inspection has been made and such connection and the wortc inaderrt tfiereto has been approved by the City as a
proper and suitabte connection.
402.06 REPAIRS AND MAtAITENANCE TO CONNECI'ION
After the initial connection has been made to the water seraice curb stop box or the sewer lead at the property line or a water senrice lead has
l�een extended to the property line for connection,the appiicaM,owner,or occupartt or user of such premises shatl be liabie for ail repairs
required to arty water line and sewer lines necessary for connection of the premises from the main to the premises. tf the property ownee
requests main#enance senrice or repairs be perFormed by tf�e C'ity,the property owner shail be charged for the costs af the mairrtenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. It sha8 be the responsibility of the applicarit,
owner,occupant or user to perform standard mairrtenance of the sewer service iine from the premises to the main including debris dearing or
root cutting and to mairrtain the water service curb stop boK for operabitity and at such height as wiff ensure that it remains above the finished
grade af the land or property. {Ref 638,1156,1191j