Meter Swap Request Number: 12671
Public Works Division
Service Request
Problem Address: 7371 Tempo Ten Requested By: Seott Se�er
Depsrtmeut: WATER Addresc: No adc�css provided
Probtem/Ias�: INSTALL AMR ME1ER Phoae Nu�aber: 763-242-3383
SchedW ed Date: 2017-01-10 5c�edule�Time: 11:00:00
�-�--'� �-�G.
ACIION NEEDED:
Cre�ed by: Wandy Hiatt Datc Created: 2016-12-30
ACTION TAKEN: `
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St�ns: In Progress Sabmitter Ha�Been �
Coatacted
Date Campteted: Complet�by:
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City of Fridley 1
Water Department �/5- �C� � `�Q '�(��
6431 University Avenue NE
Fridley,MN 55432
763-572-3566 O �Q� � •
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1/we hereby authorize the City of Fridley and/or its empioyees to do what is necessary to
replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all interior
piumbing. {Per City code 402.06} 1 also hold the City of Fridley andf its employees harmless for any damages tha#may occur while doing this
operation. This to include,but not limited to vatves,piping,walis,floors or the curb stop box and service{ine. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READIN (old meter)_� � � � ��
Name: qc{dress � 1 '�}�(1� p
X �� �'''�(
Phone Number� ��'.}� ��'� � ! Date ' 1
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Signature `� � Witness Signature
OLD METER# 1 .� � ����
OlD READING_� Z� ` fc���J�
NEW ME?ER# '�'L�I � \,,� � 1 �
NEW READING V
ERT# � �� C._� OY_'�,�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMlNISTRATION
(Ref Ord No 113,464,565,566,629,538,662,922,988,1144,1156,1191)
402.5 PERMR FEE
Prior to constrvcting or repair of any water of sewer line connecting the existing municipal system and arry house or buiidir�for whkh the
applic�tian is made,the owner or comractor shali be required to obtain a permit for wch connection,and shafi pay a permit fee as provided i�
Chapter 11 of this Code. After wcfi connection has been made,the Water and Sewer Departmesrt shall be noNfied. R sfiall be uniawful to cover
any connecting line urrtii an inspedion has been made and such connedion and the worlc Pnciderrt thereto has been approved by the Crt�r as a
proper and suitabie connection.
402.06 REPAIRS AfYD MAINTENANCE TO CONNECTION
After the Inttial connection fias been made to the water service curb stop box or the sewer lead at the property lin+e or a water senrke lead has
been extended to the property line for connection,the applicant,owner,or occupant or user of such premi�s shall be{iabie for alf repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs he performed by the City,the property owner shali be charged for the costs of the maiMenancs and/or
repairs,includin�necessary street repairs at a rate set annually by an administrative poliry. It s6aii be the responsibility of the applicant,
owner,occupant or user to perform standard mainte�ance of the seMrer service{ine from tfie premises to the main induding debrls dearing 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
grede of the land or qroperty. (Ref 638,1156,1191}