Meter Swap ` Request Number: 15443
Public works Division
Service Request
Problem Address: 148 Talmadge Way Requested By: Sharon Peckels
Department: WA'IER Address: No address p�ovi�ed
Problemllssue: INSTAL.L AMR ME'1F,R Phone Number: 572-0863
Schedul te: 2017-OS- 5 Scheduled'Pime: 01:00:00
M
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2U17-OS-18
ACTION T : � ���
1 �
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� _..........._. .._.__..�.._.._....._....__.___ _._....._.._._._....._...__.. _.___._ _...._..___._____...._________._._. _..._...._______.. _.
', Status: In Progress 5ubmitter Hns Been r,
Coot�ted
Date Completed: Completed by:
' � -25-�- I� �r-
� � City of Fridley ly � Z'�i���0 ��—
Water Departrnent � " �'^
6431 University Avenue NE �J� �G�
Fridley,MN 55432 �v � � /
763-572-3566
�/We hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. I understand that the property owner is!'sable for the water fine from the main to the premise and all i�erior
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,walls,floors or the curb stop box and seroice line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIN6(old meter) `� '`�' � � ��O
Name:�p)� `�%��� Address ���� � �
Phone Number �r��� 1�"'� �D�� Date ��� ��
Signa e �--*/ �L�•�.:�iz Witneu Signature
�
OLD METER# ��O ���!V
OLD READING O � {� ��
NEW METER# `C� (/I� ��V�
NEW READING V
ERT# � Z���I � �
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 line conneding the existing municipal system and any house or buiidit�g for which the
application is made,the owner or contractor shali be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover
any connecting line until an inspection has been made and such connection and tfie work inciderit thereto has been approved by the C'rty as a
proper and suitabie connection.
402.06 REPAIRS AND MAfN'f'ENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at tfie property tine or a water service lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall he IiaWe for all repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. ff the property owner
requests maintenance 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 potiry. It shall be the responsibility af the applicant,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main including debris ciearing 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 land or property. (Ref 638,1156,1191)
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�3-t� �9 J .-�
/���`s�City of Fridley
Water Department
Address ' �"�� �aI G �y� ��
Name_.��_n ►^c�i'l. �e-C"�'2 t�J
_ Date �- � � �� V '
Old Meter Number $ � �_
Old Meter Reading � l � � �L��
Replacement No. 6 �����
Replacement Reading �
Replacement Make 1�4. r
Remarks•
� �,
Signed
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