Meter Swap Request Number: 15456
Public Works Division
Service Request
116 Rickard Rd Requested By: Ralph Peterson
..�: WATER Address: No address provided
�aolem/Issue: INSTALL AMR METER Phone Nwnber: 763-571-b481
Scheduled Date: 2017-OS-22 5cheduled'lime: 01:30:00
P'� � ` �l
ACfION NEEDED:
' Created by: Beth Koxidrick Date Created: 2U 17-OS-I 8
ACTION TAI�
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Status: Itt Progress Submitter Haa Beea �...
Contacted
Date Completed: Completed by:
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, ` City of Fridtey ���
Water Departrnent ����
6431 University Avenue NE
Fridtey,MN 55432
763-572-3566
t/we hereby authorize the�ty of Fridley and/or its employees to do what is necessary to
replace the water meter. 1 understand that the praperty owner is liable for the water line from the main to the premise and alt iriterior
plumbing. (Per City code 402.Q6) I also hold the C'rty of Fridley and/its employees harmless for any damages that may ocwr while doing this
operation. This to inclade,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand I am atso required
to obtain a permit prior to arry work,if necessary.
FINA!METER READING(old meter) b � � ��
Name:�_l �� �QJ�"v��l�i� �ldress �� ` �/ �/
Phone Number�lV�����' ����e �/��r 1�
Signature�� �_�--_ Witness Signature
OLD METER# c���"���
OLD READING � ��� � �
NEW METER# ��������4J
NEW READING L./
ERT# � J v '
FRIDLEY CITY CODE
CHQPTER 402.WATER,STQRM WATER AND SANITARY SEWER
ADMtNtSTRATION
(Ref Ord No iZ3,464,5b5,566,629,638,662,922,988,I144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municPpal syscem and any hou�or iw(idlr�far whkh the
applicatFon is made,the owner or corrtrador shall be required to obtain a permit for such connection,and shall pay a permii fee as provided in
Chapter il of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and wch connection and the woric incidertt thereto has been approved by the City as a
proper and witable connection.
402.06 REPAIRS AND MAINTENANCE TO CONPIECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property(ine for connection,the appticant,owner,or occupant or user of such premises shall be liable for ail repairs
required to any water line and sewer fines necessary for connection of the premises from the ma+n to the premises. If the property owner
requests maintenance senrice or repairs be performed by the City,the properly owner shall be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at e rate set annually by an administrative poliry. It shall be the responsiWllty of the applicar�t,
owner,occupant or user to perform standard maintenance of the sewer senrice tine from the premises to the main including debris clearing or
root cutting and fio mairitain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grede of the land or property. (Ref 638,1156,1191)