Meter Swap . " � Request Number: 12687
Public Works Division
Service Request
Problem Address: 7398 Symphouy St Requestcd By:
Department: WA1ER Addteu: No ad�ess provided
Problem/Issne: INSTALL AMR METFR Phoee Nnmber:
Schedded Date: 2017-01-10 Schedded Tlme: 10:00:00
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AGTION NEEDED:
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C�t�eaf�d by: Wendy Hi�tt llnte Crcated: 2017-01-03
�C"�'ION TAI�N: ,
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Ststua: In Pro ss Sebmitter Has Been �., �.
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Ds�te Compl eted: � --� '��� �� y�`"��leted `V \
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City of Fridley „�
WaterDepartment ���' �jc�� b�flo '" ��
e 6431 University Avenue NE
' Fridley,MN 55432
' � 763-5723566 �j'� ��� �
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�/We hereby authorize the City af Fridley and/or its employees to do what is necessary to
replace the water meter. !understand that the property owner is liable fo�the water line from the main to the premise and all interior
plumbing. (Per City 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 include,but not limited to valves,piping,wa(Is,ftoors or the curb stop 6ox and service iine. In understand i am also required
to obtain a permit prior ta any work,if necessary.
FlNAL METER READING(okt meter) �Lv v C7 ��
Name: Address � � i CJ �y �"�1.�V�_��/ � •.
Phone Number �� p� 1,'"��� � ��
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� Signature Witness Signature
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OLD METER# �����,� �;�L,� �
OLD READtNG ���`'' � v C �
NEW METER#
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NEW READING �
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FRtDLEY CtTY CODE
CHAPTER 402.WATER,SfORM WATER AtYD SANfTARY SEWER
ADMtNI5TRA77QN
(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 line connecting the existing municipal spbem and arry house or buildi�for which the
apptication is made,the owner or contractor shait be required to obtain a perm�t for wch connection,and shalt pay a�it fee as provided i�r
Chapter 12 of thes Code. After wch connection has been made,the Water and Sewer Departmern shali be n�ed. it shall be unla�aful to cover
any connecting line untii an inspection has 6een made and such connection and th�wo�lc inaderK thereto has been approved by the City as a
proper and suitabte connection.
402.06 REPAiRS AND MAtN'ffNANCE TO COiMIYECTION
After the initiai connection has been made to the water senrice curb stop box or the searer lead at the property line or a water senrice lead has
been eztended to the property line for connection,the appiicarrt,owner,or accupant or user af wch premises shalt be IiaWe for all repairs
required to any water fine and sewer(ines necessary for connection of the premises from the main to the premises. ff the properly owner
requests mairitenance seroice or repairs be performed by�he City,the property owner shall be charged for ihe costs of the mairrtenan�and/or
repairs,includi�g necessary street repairs at a rate set annuaily by an administrative poltry. It shall be the responsibil'rty di the applicarit,
owner,occuparit or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to mairrEain the water service curb stop box for operability and at such height as wi(I ensure that it remains above the finist�ed •
rade of the lartd or ro ' �
� P I�+'�1/• (Ref 638.1156,2191j _
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