Meter Swap .
t
Request Number: 16160
Public works I�ision
Service Request
Probl em Address: 8160 Ruth St Requested By: Michael Malmborg
Department: WATER Address: No address provi�d
ProWem/Issue: INSTALL AMR METER Phone Number: 763-784-1134
Scheduled Date: 2017-06-28 Sc6eduled 1Ime: O8:OU:00
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ACIION NEED�D:
Created by: Beth Kondrick Date Cre�ted: 2017-06-27
ACIYON T
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Status: In Progress Snbmitter Has Been r,
Contacted
Date Coa�pleted: Completed by:
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; �City of Fridley
, Water Department �� � ��'jC,av
6431 University Avenue NE
Fridley,MN 55432
7C3-572-3566
��1Ne hereby authorize the City of Fridtey and/or its employees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all ir�terior
plurnbing. (Per Gty code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to inctude,but not limited to vatves,piping,walts,floors or the curb stop boz and service line. In understand!am aiso required
to obtain a permit prior to any work,if necessary.
FINAL METER READING{oid meter) �� �����
Name: ��L��/' V"W��� Address ��1dJ �� �"�
Phone Number� ��� `� �I�-1 p� �~ �k�' '� II�
Si n e � � %"'/
�r� Witness Signature
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OLD METER#_�� �`7 E> 1 1 O
OLD READING�� /J��—`V _
NEW METER# �� �O ��
NEW READING�
ERT# � ZZ�� �� �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINlSTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer iine connecting the existing municipal system and any house or twildir�fo�which the
application is made,the owner or corrtractor shall be required to obtain a permit for such connection,and shall pay a�rmit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shail be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the Crty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTIOfV
After the initial connection has been roade to the water service curb stop box or the sewer lead at the property line or a water service iead has
been eutended to the property line for connection,the applicant,owner,or occuparit or user of such premises shall be IiaWe 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 meintenance service or repairs be perFormed by the C'rty,the property owner shail be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annually by an admi�istrative poliry. It shall be the responsibility aF the applicant,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main including debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the(and or property. (Ref 638,1156,1191)