Meter Swap ` Request Number: 12478
Public Works Division
Service Request
Probtem Address: 7498 Melody Dr Requested By: Alecia Jtgge�on
DepArtmeut: WATER Address: No address provided
Problem/Isa�: 1NSTALL AMR METER Phone Number: 763-'741•7952
Schednled Dat� 2016-12-23 � Sc6ed�led 1lme: 09:00:00
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ACTION NEEHED:
GYeated by: We�y Hiatt Date Created: 2016-12-1 S
AClI01�TAI�N:
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St�: In Progress Snbmitter Hu Beee �
Co�uted
Date Completed: Completed by:
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City of Fridiey � � � ��� 3
Water Department
+ 6431 University Avenue NE '� L�--���� /�� '"6�
Fridley,MN 55432
763-572-3566
�/+Ne �.i.Ec ai,� ��'-��'�i Y in'Sz��^- hereby authorize the City of Fridley and/or its employees to do what is�ecessary to
replace the water meter. I unders nd t6at the property owner is tiabte for the water fine from the main to the premise and ail interior
plumbing. (Per City 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,walis,floors or the curb stop boz and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) a a a 5 �3�
Name:�,� '�,�����i'`��1' I�1' , qddress
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Phone Num r . '�� Date ��� /��� �
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�ignature �✓ Witness Signature
OLD METER#�� / o�.� �, ( Y/
OLD READING � 1 ��d ��
NEW METER# � ( I � � / �I
NEW READING �
ERT# C� ��� 'O � � ,
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to construding or repair of any water of sewer line connecting the exlsting municipal system and ar�y house or building for which tNe
application is made,the owner or contractor shail be required to obtain a permit for such connectioe,and shali pay a permit fee as provided in
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer DepartmeM shall be not�ed. It shall be unlawful to cover
any connecting line ur�til an inspection has been made and such connection and#he work incideM thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAMTENANCE 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 senrice lead has
been extended to the property line for connection,the appiicant,owner,or accupant or user of wch premtses shall be liable f�all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the prem'�ses. if the property owner
requests maintenance senrice or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including deb�is dearing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)