Meter Swap � �, Request Number: 12589
Public Works Division
Servtce Req�st
Probtem Address: 7467 Melody Dr Requested By: Paljo�u
Dep�rtmeat: WA'IEIt Address: No address provided
Problem/Issne: INSTALL AMR ME1F.R P�one Number: 612-978-5995
Schednled Date: 2016- 2-30 _.�t, Sch�dale�13me: 01:00:0(1
1
ACIION NEEDED:
G�eated�: We�iy Hiatt Date Cre�ed: 2016-12-2�
A�C.`IION TAi�N:
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Dxte Comp�eted: �a�- 3(�}r ,� Campleted by:
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City of Fridley
Water Department
6431 University Avenue NE �/��5����
� Fridley,MN 55432 � 1 �---
� 763-572-3566 �� I �° � C�
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�/We hereby authorize the City of F�idley and/or its employees to do what is necessary to
replace the water meter. 1 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 the City of Fridley andrts 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 1 am also required
to obtain a permit prior to any work,if necessary.
�.s� �� —l�/(� � .
FINAL METER READING(old meter) �`
Name: �Q,1�k'Str� Address /� �� ��'� w � ��Y�, •
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Phone Numbe �-�2^ ����� Date_ �/+`��"'�
. '�Signature_ _—
Witness Signature �'���
OLD METER# ` ✓ / J J ✓�
OLD READING � �� Q—( ��
NEW METER# �� �� � � � �
NEW READING �
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FRIDLEY CITY CODE
CHAP'TER 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 constructing or repair of any water of sewer line connecting the existing municipal system and arry house or buildir�for whfdi the
application is made,the owner or coritractor shall be required to obtain a permit for such�nnection,and shall pay a permit fee as provided in�
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notified. It shali be unlawful to wver
any connecting line urrtil an inspection has been made and such connedion and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the pro�erty Itne or a water senrice lead has
been extended to the properly line for connection,the applicant,owner,o�occupant or user of such premises shaii be liabk for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance senrice or repairs be performed by the City,the property owner shail be charged for the costs aF the maiMenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perPorm standard maintenance of the sewer service line from the premises to the main including debris dearir�g or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the ftnished
grade of the land or property. (Ref 638,1156,1191)
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