Meter Swap Request Number: 12351
, Public works Division
_ � Service Request
Problem Addresa: 7321 Memory Ln ��L Requested By: Co�ta�e Ahrens
Departtaeat: WATER Addres:: No a�fress provided
ProblemJjss�: INSTALL AMR METER Phone Nn�ber: 763-784-1785
Schedaied Date: 2016-12-09 �� Sciied�isd 1ime: 10:3U:00
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Ae'TION N�EAED:AMA:V�if t�i1��Ni�4�iweit e�.
Creata��y; Wendy Himtt Date Ceftated: 2016-12-OS
ACIION'�' . _ �_�--�
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___�____� `�
Stntus: In Fro�ess S�bmitter Aa�Been r,
Contacted
llnte Completed: Completed by:
l2- �I � 1 � �
City of Fridley � r�.� � ���
Water Department �-
6431 University.Avenue NE
Fridley,MN 55432
� I��-/S�S�-��
763-572-3566
,,�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. t understand that the property owner is{iable for the water line from the main to the premise and all iMerior
plumbing. (Per City code 402.06) I aiso hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to vatves,pipi�g,walls,floors or the curb stop box and servite line. fn undersWnd 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(oM meter) � � ��v ` �l �Y✓,
Name: l���)`�•1(`�. /�'V►�� Address ���`
Phone Number l t V�� ���� �1 t�� Date `��� '� 4�
� Signature t.��y� �� Witness Signature
OLD METER# � � �� ��� `'�
OLD READING "! � 'l 1 � _ �
-
NEW METER# _ Y { Y ��� ��
NEW READING
ERT# �� � �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRA710N
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to oonstruding or repair of any water of sewer line connecttng the existing municipat systerr�and any house or building for which the
application is made,the owner or contractor shall be required to obtain a permFt for such connedion,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 shall be notified. It shall be unlawful to co+rer
any connecting line until an inspection has been made and such wnnection 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 property line or a water service lead has
been extended to the property line for connection,the applicant,owner,or occuparrt or user of such premises shall be liable for all repairs
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 maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali be the responsibility of the appiipnt,
owner,occuparrt or user to perform standard maintenance of the sewer service line from the premises to the main including debris deartng or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191�