Meter Swap � � � � �
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�tater�epa�ment �� � ��3 cf
6431 l7�aiversity Avenue NE
Frislley,NlPI 55432
763-572-3566
o�7Ve hereby authorize the City of Pridley artd/or its employees to sJo what is necessary to
replace the arater meter. t understand that the property owner is liable for the water line from the main to the premise and all irrterio�
plumbing. (Per City code 402.06j I aiso hold the Crty of Fridiey and/its employees harmless#or acry damages that may occur while doing this
operatiom. This to inctude,but not limited to valves,pipin�walis,floors or the curb stop box and senrice line. In understand I am also require
to ahtain a permit}srior to any work,if necessary.
FINAL METER READIN6(old meter) � ��� �
Name• Address_ 1�� ��� t7��
Phone 94umber p�e "� �V`�l
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Signature Witness Signature
OLD lViETER#___ � �Qj�) � �7`� .
OLD READlNG � ���j S�
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NEW METER# � � •✓ � �,�, :
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NEW READlNG _ (�
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ERT# ! � `� I `! p�i �x J
FRIDLEY CITY CODE
CHAPI'ER 402.WATER,STORM WATER AND SANITARY SEWER
A�MINISTRAl'ION
4�tef Ord No 113,464,565,566, 624,638,662,922,988, 1144,1156,1191) .
402.5 PERMIT FEE
� Prior to constructing ar repair of any water of sewer line connecting the existing municipal system and eny house or building for which the
application is made,the owner or corttractor shell be required to obtain a permit for such cannection,and shall pay a permit fee as provided in`'
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Oepartrnerrt shaN be notified. it shall6e unlaarful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved 6y the City as a
proper and suitable connectio�.
402.06 REPAIRS AiYD MAIPITENANCE TO COPINEC770N
After the initial connection has been made to the water service curt=stop hox or the sewer(ead at the property line or a water service lead has
been extended to the property line for connection,the applicarrt,owrter,or accupant or user of such premises shall i�e liabte for ail repairs
required to any water line and sewer lines necessary#or connection of the premises from the main ta the premises. If the property owner
requests mairrtenance service or repairs be performed by the Crty,the property owner shall be charged for the costs of the mair�tenance and/or
repairs,including necessary street repairs at a rate set annualty by an administrative policy. It shall be the responsibitity of#he applicanfi,
owner,occupant ar user to perEorm standard mairrtenance of the sewer service line from the premises to fihe main including debris dearing or
root cutting and+to maintain the water service curb stop 6ox for operability and at such height as will ensure that it remains above the finished
grade af the land ar property. (Ref 638,1156,1191)
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REQUEST FOR SERVICE REPORT
CITY OF FRIDLEY
Reference No. Date: g�-(�.-� `z
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Request Type: Entered By:
Department: Citizen Name: /�R`� �?��
Address: ��3 �['p������ Phone Number:
Scheduled Date: Property Owner:
Location Details: Request Details:
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Action Taken:
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Responsible Person: 5�
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� Approver: `;
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Completion Date: ���� Citizen Notified:
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