Meter Swap ' Request Number: 12619
Public works Division
Service Request
Problem A�ddres`: 7380 Te�o Terr Requested By: Nelson Ortiz
Departme�: WA'IER Addr�ss: ?38Q Te�o Terr
Fridlcy,MN SS432
� Probiem/Lsue: INSTAI.L AMR METER Phone Nuenber: 612-SO1-6683
Schednled Date: 2017-01-OS Scbeduted 11ms: Ol:30:00
� � 3
AC110N NEEDED:I�tall AMit
Created by: Beth Kon�-ick Date Cre�ed: 2016-12-29
ACIION T .
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5tatus: In Progress 5ub�itter Hae Beea �
Coutscted
Date Ca�pleted: Completed by:
✓�
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City of Fridley � (
Water Department S�/ I � �
6431 University Avenue PIE y� ��
` Fridley,MN 55432 � (���- � �
' 763-572-3566
UWe hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. t understand that the properiy owner is liable for the water line from the main to the premise and all interior
plumbing. (Per City wde 402.06) 1 also hold the C'ity of Fridley and/its empioyees harmless for any damages that may occur whiie daing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READlNG(ofd meter) ���� �` �
Name: �V�`�� � v r T r C.�— Address � J 1 �� � '�i��
Phone Number1 ��� � ' Date , � � l
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Signature C Witness Signature
OLD METER# �� � � �� ��
OLD READING �-� ��'��
NEWMETER#��,����+��
NEW READING �
'��V/
r
ERT#_�Q ��� �V��
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CHAPTER 402.WATER f :�.���...�
1
. �
(Ref Ord No 113,464,565,5 �
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402.5 PERMIT FEE ��,��
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Prior to constructing vr repair of any water of sewer line conr / � q� � iilding for which the
application is made,the owner or corrtractor shali be require� f� D � �ermit fee as provided i�
Chapter 11 of this Code. After such connection has been mad �� /� shaii be unlawfu{to cover
any conaecting line until an inspedion has been made and su . �/`�- E'� � proved by the City as a
proper and suitabie connection. ` `�
, ���
402.06 REPAIRS AND MAINTENANCE TO CONNECTION f�' � �'1�d"Q
!d � �
After the initial conneetion has been made to the water servi� �` � (1n�� a water service lead has
been extended to the property line for connection,the applic� � v tiabie for all repairs
required to any water line and sewer lines necessary for connection of the premises r�om tFe main to iTie premises. If the property owner
requests maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shali be the responsibility of the applicarrt,
owner,occupant or user to perform standard mair�tenance of the sewer service line from the premises to the main inciuding debris clearing 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 638,1156,1191j