Meter Swap Request Number: 12471
Public Works Division
Service Request
ProMem Address: '7424 Melody Dr Requested By: Williazn Holm
Departmeut: WATER Address: 7424 Melody Ik
Fridley,NiN 55432
ProbiemJIssue: INSTAL.L AMR ME1ER Phone Number: -- �63-180-2013
Sc e e: 20t6-12-21 SchednledTime: O1s30:00
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AC'IION NEEDED:Install AMR
Crented by: Beth Koudrick Date Cre.ated: 2016-12-15
A(,TION TAKF'.N:
-�,�S�,,�\�-.�- ����
� Snbmitter Aas Been
��°8: ��O � Contacted r
Date Completed: ( ") , '1 ' ,,, �� Completed by:
C�< O�
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City of Fridley �
Water De artment � � � � � �
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6431 University.Avenue NE �� � a - ����v �(
Fridley, MN 55432
763-572-3566
�/We �""`�`��'�� ��\��' hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. 1 understand that the prope�ty owner is liable far the water{ine from the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City aF Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to inciude,but not limited to valves,piping,walis,floors or the curb stop boz and servtce tine. in understastd 1 am atso required
to obtain a permit prior to any work,if necessary.
.,..
FtNAL METER READING(old meter) ��� � ` "
��
Name:-����t��"" �,O lv"'` Address ` `t �"1 �'E'�U�y �r
Phone Number C�R�� � U U'"� �� Date ��-- ' �� ' � �
Signature �� �� Witness Signature ��`? 1�`��
OLD METER# 3 3 a � � � 33
� OLD READING � �� � ��
NEW MfTfR# �� �� V ! � � �
NEW READING U
ERT# � V$5 ` 3� � ,
ERIDCEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of arry water of sewer iine connecting the existing municipal system and ariy house or building for whlch the
appfication is made,the owner or contrador shali be required to obtain a permtt for such connettion,and shaN pay a permit fee as provided io
Chapter 11 of this Code. After such co�nection has been made,the Water and Sewer Department shatt be notlfied. It shail be unlawful to cover
any connecting line unti!an inspection has been made and such connedion and the work inctdent thereto has been approved by the Cily as a
proper and suitable connettion.
402.06 REPAtRS AND MAIM'�ENANCE TO CONNECTfON
After the initial connedion has been made to the Mrater service curb stop box or the sewer lead at the property Pne or a water service lead has
been extended to the property fine for wnnection,the applicaM,owner,or occupant or user of wch premises shall be IiaWe for all repairs
required to any water fine and sewer lines necessary for can�ection of the premises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by Che City,the property owner shali be charged for ihe costs of the mairttenance and/or
repairs,including necessary street repairs at a rate set annualiy by an administrative policy. It shall he the responsibility of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer service line from the pcemises to the main includi�debris dearing or
root cutting and to maintain the water service curb stop boK for operability and at wch fieigtrt as wiff ensure that n remains above the fintshed
grade of the land or property. (Ref 638,1156,1191)