Meter Swap `'� Request Number: 13094
Public works Division
Service Request
Problem Address: 1544 Osborne Rd Requested By: Mary Kay L,awre�e
Department: WATER Address: No address provided
Problem/Iasue: INSTALL AMR ME1ER Phone Nember: 763-785-9559
Schednled Date: 2017-02-06 �� Sc6ednled 1ime: 10:00:00
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ACIION NEEDED:
Created by: Wend�y Hiatt Date Created: 2017-01-26
ACTION T.�I�N:
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Status: In Progress Submitter HAs Been �
Contacted
Date Gompleted: Completed by:
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1Nater�e�artrnertt
5431 lOniversity Avenue NE ��' � � �� � ,:
Fridley, MN 55432 ?
� 753-572-3566 �� i 'Z V � l C� )c��-._�j 3 �
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�jw� her�by authorize the City af Fridley and/or its empioyees to do what is necessary to
replace the wafier sneter. 1 understand thai the property owner'ss liabie for the�erater line from the main to the premise and al{interior
p{umbing. (Per C'rty code 402.06) i also hold the CRy+of Fridley andfits employees harmless for any damages that may occur�erhile daing this
operation. This#o incfude,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand!am alsfl require�
to obtain a permit prior to arry�ro�c,if necessary.
FtNA1L ME'fER READING(o(d meter) � �� � � �
Name: ��� �� �R,.
Phone Number��Q�"'�d� 1� �Q� l
Darte
Signature Nf�tness Signature
OtD METER# �J�� � � � �
OLD READIN6__G.c.1 Z�-� V�_
NEW METER# " � (J���CO� 1
NEW READING�
ERT# , �
FRIDL�I CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,9$8,1144,I156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the e�cisting muniapal system and atry house or building for which the
applYcation is made,the owner or corrtractor sha(1 be required to obtain a permit for such connection,and sha{i pay a permitfee as provided irr
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Depastmes+t shali be notif�'�ed. tt shaN be uniawfui to cover
any connecting line until an inspection has been made and such connection and the work inciderrt thereto has been approved by the City as a
proper and witable connection.
402.06 REPAIRS AND MAfNTENANCE TO CONNECf10N
After the initiel conneciio�has been made to the water service evrb seop 6oK or the sewer lead at fihe property liae or a water service ieacl t�as
been extended to fihe property line for con�ection,the applicarrt,owner,or accupant or user of such premises shati be Itabie{or ai{repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the prc►perty owner
requests mairrtenance service o�repairs be perFormed by the City,ihe property owner shali be charged for#he costs of the maintena�tce and/or
repairs,including�ecessary street repairs at a rate set annuaily by an administrative policy, it shall be the responsibilit�of the applicarit,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises Co the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiil ensure that it rerr�ains a6ove the finished
grade of the land o�property. (Rei 638,1156,1191J