Meter Swap Request Number: 15931
Public Works Division
Service Request
Problem Address: 7879 Pearson Way Requested By: Linda Sulliv�m
Department: WAZER Address: No address�ovided
Problem/Issue: I�iSTALL AMR ME'tER Phone Number: 574-9829
SchedWed Date: 2017-06-]5 Schednled 1lme: 01:30:00
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AC'ITON NEEDED:
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Created by: Wendy Hiatt D�te Created: 2017-06-12
ACTION TAI�N:
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Status: In Progress Submitter Has Been �.,
Contacted
Date Completed: Completed by:
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t431 lJniversity Aareroue NE � � J/���
Fr�dley,MN 55432 Y�
763-572-3566
�I'"�e hereby authorize the Crty of Fridley and/or its employees to do what is aecessary to
replece the water meter. t understand that the property owner is liabfe for the water line from the main to the premise and all irrterior
plumbing. (Per�ity code 402.06) 1 also hoid the City of Fridley andrts employees harmless for any damages that may occur while doing this
operatiom. This to include,but not limited to valves,piping,walis,floors or the curb stop box and senrice line. In understand 1 am also requirE
to abtain a permit prior to any work,if necessary.
FINAL METER READ{MG(oid meter) ✓�����
Name: ��� W����� Address� F��v` ����� �
Phone Number J l� \ ^� � D� ���'-� b
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Signature Witness Signature
OLD METER# _ ���`I ` ?j� I
OLD READtNG _ �� 1�� CX/
ntEW METER# -1�� ��1 [.�
NEW READINC;�
E�# � 23�� �q �
FRIDLEI!CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMtRIISTitATlO{it
(�def Ord Rio 113,464,565,566,629,638,662,922,988,1144,1156,1191)
4Q2.5 PERIIAAIT FEE
P�ior to constructing or repair of any water of sewer line connecting the extsting municipal system and any house or bui(ding for which the
application is made,the�nr�er or contractor shalf be required to abtain a permit for sutf�connection,and st�afl pay a permit fee as provided in
Chapter 11 of Yhis Code. After such connection has been made,the Water and Sewer Departmeat shalt be nofified it shail be unla�wful to cover
any connecting line until an inspection has been made and such connection and the wortc incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPA(RS AND MAINTENANCE TO COPINECTION
After the initial connectio�has been made to the water service curb stop box or the sewer tead at tfie property line or a water service(ead has
been ax�tended to the progerty line for r.onnection,the appltcarrt,owner,or occuparrt ar user of such premises shall be liable for alt repairs
required to any water line and searer lines necessary for connection of the premises from the main to the premises. If the gro�rty oarner
requests maintenance service or repairs be performed by the C'it}r,the property owner sha(I be charged for the costs of th@ maintenance and/or
repairs,including necessary street repairs at a rate set annuai(y by an administrative policy. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard mairrtenance of the sewer service line from the premises to the main including tiebris dearing or
root cutting end to rnairrtain the rvater service curb stop box for operabitity and at such height as wiil ensure that it remains above the finished
grade af the land or property. (Ref 638,1156,1191)