Meter Swap ' Request Number: 14524
Public Works Division
Seivice Request
Problem Address: 7372 Sympho�+St Requested By: Cindy Schreiner
Department: WATER Address: No address provided
Problem/tssue: INSTALL AMR METER Phone Namber: 763-786-2772
Sched e e: 17-04-12 � Scheduled 1ln�e: 10:00:00
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ACIION NEEDED:
Created by: We�y+Hia�t Dxte Cre�ed: 2017-04-OS
AC'IiON TAKEN:
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Status: Tn Progress Submitter Hrs Been r,
Contacted
Ds�te Completed: �.Q� '�..._ �� Completed by: � C L� t :°
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' City of Fridley �� �-'l ��
Water Department
6431 University Avenue NE
Fridley,MN 55432
763-572-3566
�/we hereby authorize the�ty of Fridley and/or its employees to do what is necessary to
replace the water meter. i understand that the property owner is liable for the water line from the main to the premise and ail interior
plumbing. (Per City code 402.06) 1 also hold the C'ity of Fridley and/its employees harmless for any damages that may occur while doi�this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am aiso required
to obtain a permit prior to arry work,if necessary.
FINAL METER READING(old meter � 5 a��� �
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Name• ��� ��''�,1�- � `Q.V Address
Phone Number {��J-�CJIS� ���p�@ � � I�, `� '�
Signature Witness Signature
OLD METER#���� ��O
OLD READING ��� �� � �
NEW METER# � I �O � �� �
NEW READING v
ERT# �� �W1
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(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 fine wnnecting the existing municipal system and any haise or buiWing for which the
appiication is made,the owner or coMractor shall be required to obtain a permit for wch connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to co�r
any connecting line until an inspection has been made and such wnnection and the work incident thereto has been appro�d by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connedion has been made to the water service carb stop box or the sewer lead at the property line or a water servke lead has
been extended to the property line for conoection,the appiicant,owner,or occupant or user of such premises shail be liable for all repairs
required to any water line and sewer lines neceuary for connection of the premises from the main to the premises. If the property w�rner
requests maiMenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative policy. it shall be the responsibility of the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main induding debris clearing or
root cutting and to mair�tain the water service curb stop box for operability and at such height as will ensure that it remains above the�nished
grade of the land or property. (Ref 638,1156,1191j