Meter Swap ' Request Number: 13231
Public works Division
Service Request
Problem Address: ?360 Stinson Blvd Reqaested By: Bernard
Departme�: WA1ER Address: 7360 Stinson Blvd
Fridley,MN 55432
Pro�em/Issue: INSTAL,L AMR ME1ER Phone Numbers 763-786-4033
&heduled�— 2017-02-07 � Sc�del�d Time: 11:30:00
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ACIION NEEDED:
Created by: Beth Kon�ick Date Created: 2017-02-02
ACTIUN T .
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Ststus: Ia Progress Submitter H�Beee r
Coetacted
Date Completed: Completed by:
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�431 i9niv�rsitqf�►rre�a�te W� � (� p��� �
�riel[�ey,MP! 5543Z
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t/�1°� hereby authorize the�'rty vf�ridley andls�'rts emp(oyees to do what ds necessary
�e�alace the wa$er meter. ��ncierstand tt+at fihe propea-ty owner is liable for fihe serater line�rom the main to ttee premise and all irrterior
plumbing. (Per City code d02.06� i alsa�oid the C.it�/�#�stidley and/'rts employees harmless for any damages that may�nccur while doing th
o�oea�tion. 7'his#o snctude,but no4 limited to valves,p�ping,wails,floars or#he turb stop box and service)ine. In understand 1 am also req�
to oiatain a permit prior fio any�eror4c,�f necessary-
FiNAL!IR R READIAIG�old mefierj �� � ���
Atame: l7 Address � ��v (�T���7✓V\. \J
Phone Number �K/����_t���i� p� �-�� ��
Signature �"''� � YVitness Signature
OLD METER# �� �� � Z �pJ
OLD READt1YG "v� 1 ���
NEW METER# "� �� I � �
IVEW READlRtG �
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Fti1DLEY CI'!'Y CODE
CHAPTER 402.WATER,STORM WATER AND SANCCARY SEWER
ADMINISTRATION
�Ref Ord NO 113,464,565,�66,629,638,662,922,988,I144,IZ56,1191}
402.5 PERMiT FEE
Prior to constnacting or repair o#any water of server iine connecting tF�e existing muniapai system arut arry house or buiidir�for irhich the
apptication is made,the owner or cor�tractor shait be required tv obtain a permit for such connection,and shaQ pay a permit fee as provided i
Chapter 11 of#his Code. After such connection has been made,the Water and Sewer Departmerrt shall be notified. It shail be unlaaiful to co�
arry connecting(ine urrtii an irrspection has been made and such connectaon and the wortc inciderrt thereto has been approxed by the Gty as a
proper and sui#abte connection.
402•06 REPAIRS AND MAINTEIY�INCE TO CONIYEC170N
After the initial connection has been made to ihe water service curb sto�box or the sevrer iead at the propetty�line oc a�ratQr servioe lead ha;
been extended#o fihe property line for connection,the applicant,orrner,or accupan#or user of such premi�s shalf be(iabie fpr a1�r,epairs
required to any water line and sewer lines necessary#or connection of the premises from the main to the premises. !f the property owner
requests mairrtenance service or repairs be perFormed by the City,the property owner shafi be cfiarged for the costs of ihe rnairrtenar�ce and/�
repairs,including necessary street s�epaqrs at a rate set annualty!�art administrative poliry. it shat!be the responsi6il'rty of the a�licarrt,
owner,ocsupartt or user to perfiorm standard mairrtenance of the se�yer service line from tf�e premises to the main including de(xis dearing or
root cutting and to mairrtain the water service curb stop box for operability and at such 6eight as wili ensure that it remair�s above fihe finishec
grade of the land or p�operty. {Ref 638,1156,1191)