Meter Swap , Request Number: 15617
� Public Works Division
Service Request
Problem Address: 331 Peazson Way Requested By: Robert Mi�ish
Departmeet: WA7ER A�ddress: No a�ess provided
Problem/Issue: INSTALL AMR ME1ER Phone Number: 763-571-6162
5ehedWed Date: 2017-06-02 - f 5chednled Tlme: 02:OO:UO
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AC'I�'ON NE�DED:
Created by: Beth Koad�ick Ds�te Createdc 2U17-OS-30
AC'IION TAI�N:
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Status: Iu Progress 5nbmitter Has Been r.
Contacted
Date ComQleted: Camp�eted by:
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�'�,����a�ey 3� 3-s 1� � t� �a I
Wa#er Depa�rr'ent
b431�n6versity Avenue NE Sp� � C�
� Fr�d9�ey, MN 55432 �J
' �'/' � 763-572-3556 , r �� /_
�/we �/ ��� ��
hereby authorize the Crly of Fridley and/or its empfoyees to do what is necessary to
repiace the water meter. t understand at Che property owner is liabte for the water line from the main to the premise and alt iMerior
plumbing. (Per L'ity code 402.06) I aiso hold the Crty of Fridtey andrts employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to val�es,piping,walis,floors or the cur6 stop hoK and secvice line. in understand l am aisa require
to abtain a permit prior to any worbc,if necessary.
FBNAL METER READIN6{old meterj
Name: Address
Phone 9Yumber Date ��-"� �
Signature Witness Signature
OLDMETER# O� J����1�'
OLD READING 2S���IO
, . _ _---__ —_ �,
N��,��E�# II IIIIIIIIIIII�III��III�
IIIIII
p � 49226051 .
NEW READING �-- _ ---_
E�-�-# 111111111111III 1111111 E
—� '11 72355069
FRIDLfY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SAPIITARY SEWER
ADMINISTRATION �
(tief Ord Nm 113,464,565,566,629,638,562,922,988,1144,1156,1191]
402.5 PERMIT FEE
Prior#o constructing or repair of any water of sewer line connecting the existing municipal system and arry house or 6uP(ding for which the
apptication is made,the owner or w�tractor shali be required to obtain a permit for such connection,and shafl pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shali be nofified. It shali be un(awfui to cover
any connecting line urrtii an inspection has been made and such connectian and the work incident thereto has been approved 6y the City as a
proper and suitable connectiort.
402.06 REPAIRS ANQ MAINTENANCE TO COPIPlECT10N
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 fihe property line for connecfio�.the applicarrt,owner,or occupasrt or user of such premises shail be liabie for alt repairs
required to any water line and sewer lines necessary for connection of the p�emises from the main to the premises. ff the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mainitenartce and/or
repairs,including necessary street repairs at a rate set annual(y by an administrafive poliry. It shall be the responsibility of the applicant,
owner,occupant or user to perform standard sssa'srrtenance of the sewer service line from the premises to the main inciuding debris dearing or
root sutting and to maintain the water service curb stop box for operability and at such height as wilt ensure that it remains above the finished
grade ofi the►and or property. (Ref 638,1156,1191j