Meter Swap Request Number: 12515
~ Public works Division
Service Request
Problem Addresa: 7398 Memory Ln Requested By: Ben Seigley
Dep�rtmeM: WA'lER Addresa; No adcfrcss provided
Problem/Iss�: INSTALL AMR METER Phone Number: 763-786-5608
Sekedoled llnte:,, 2016-12-23 � 5c�ednled Tlme: 01:00:00
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ACTION NEED :AMR
Cratted by: Wendy Hi�t Dste Cre�ed: 2016-12-19
ACIION AI�N: .
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St�: In Progress Snbmitter H�Been L,
Ceetacted
Dxte Compfeted: Gompleted by:
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City of Fridley C �'� I � � ��
Water Department J
6431 University.Avenue NE t�5�� ����,
Fridley,MN 55432 ��
. 763-572-3566
I/we hereby authorize the City of Fridley and/or its emptoyees 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 and/its employees harmiess for any damages that may occur while doing this
operation. This to include,but not timited to valves,piping,walis,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.
FINAL METER READING(old meter)��`� � ���
Name• � �� `� Address�� \� �y���� �-�✓ �,
Phone Number �� � Date 6 l�-� v�� � �
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a� ��� ��ti� ;;�►,�'��� ��,...
Si ature Witness Signature
OLD METER#
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OLD READING�/� O � 4 D �
NEW METER#_rC / �� 6/���
NEW READING v
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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 constructing or repair of any water of sewer line connecting the existing municipal system and any house or buildi�for whidi the
application is made,the owner or coMractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided irr
Chapter li of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shall be unlawful to co�r
any connecting line until an inspection has been made and such connection and the work inaderrt thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC770N
After the initial connection has been made to the water service arb stop box or the sewer lead at the praperty line or a water service lead has
been extended to the property line for connection,the appiicant,owner,or occupaM or user of such prcmises shali be liable for ali rcpairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mairitenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main includirig debris clearing or
root cutting and to maiMain the water service 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)