Meter Swap .
Request Number: 12725
Public wor�.s Division
Service Request
Problem A�d�reaa: 7370 Tempo Ten Requested By: Darlys Nelson
Dep�rtme�: WATER Address: No address providcd
Problem/Ias�ce: INSTALL AMR METER Phone Nnmber: 763-�84-8684
Scheduled D�e: 017-01-OS Sctiedaled 11a�c: I0:30:00
�' � 3
ACIION NEEDED:
Created by: Wendy Hi�t Drte Cres�ed: 2017-01-04
AiC.'IIO TAI�:N•
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St�: In Pro ss Sabmitter Has Been r �� �,�`�`;.
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Date Compteted: Completed by:
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City of Fridley �� 1 �� �
� Water Department �
, 6431 University Avenue NE
Fridley,MN 55432 '��s-5�- 1 I ���
763-572-3566
�/We hereby authorize the City of fridfey and/or its emptoyees to do what is necessary to
repiace the water meter. 1 understand that the property owner is liable for the water line trom the main to the premise and all interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/'rts employees harmless for any damages that may occur while doing this
operation. This to incfude,but not limited to vatves,piping,walls,ftoors 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 READING(old meter) � � � � ��
Name: �4��1r�g ' "�LL✓�� Address���� ��--Y•`� ���
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Phone Number����� ������ 1 Date ,� `.� `�
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Signature . �/�W IM�tness Signature
OLD METER#�� t�_1 �� v
OLD READING_��� �� s�!�
NEW METER#�_L {`��D v��
NEW READING�_
ERT# ���� " � � �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j
402,5 PERMIT FEE
Prior to constructing or repair of any water of sewer tine connecting the existing municipal sys�tem and aml house or butldi�for wbich d�e
application is made,the owner or coMractor shall be required to obtai�a permit for such connection,and shall pay a permit fee as provided irr
Chapter il of this Code. After such connection has been made,the Water and Sewer Departmer�t shall be notified, it shall be unlawful to c�ver
arry connecting line untif an inspection has been made and such connection and the work incide�t thereto has been apprwed by the CPty as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connectio�has been made to the arater service curb stop box or the sewaK lead at the property line or a water servi�kad has
been extended to the properly line for connection,the applicarit,owner,or occupant or user of such premises shall be liabie for all repairs
required to any water I��e and sewer(ines necessary for connection of the premises from the main to the premises. If the property oarrter
requests mair�tena�ce service or repairs be performed by the Clty,the property owner shall be charged for the costs of the mairrtenance and/�
repairs,inciuding necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicar�t,
owner,occupant or user to perform standard mair�tenance of the sewer service Iine from the premises to the main inctudir�debris dearing or
root cutting and to mairrtain the water service curb stop box for operabil'ity and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)