Meter Swap ' {
,, Request Number: 12684
Public Works Division
Service Request
Problem Address: ?508 Tempo Terr Requested By: Arthur L,anglais
Department: WA1ER .A�ddress: 7508 Tempo Ten
Fridlcy,MN g5432
ProMetnfIs:+�e: INSTALL AMR METER Photte Number: 763-784-9622
Scheduled I�ta: 2017-01-�3 Scl�duled Tlo�: 08:30:00
.r-� 3�
ACTiON NEEDED:Install AMR
Created by: Beth Kon�ick Data Crcated: 2016-12-30
AC.'1ION TAI�N: � h
,� -� �` S �1,��w � ��
Status: 1n Pmgress �bmitter Hu Been r.,
Cenit�ted
D�t�Compieted: }-- � .— �� Completed by: /7/����„
1 (,ti
Gity of Fridley
Water Department
� . 5431 Uni.versity Avenue NE
� Fridley MN 55432
� (763) 572-3561
Uwe hexeby authorize the City of Fxidley an.d/or its
empIoyee�to da what is necessary to shut offthe wa�ter at the cucb stop box I im,derstaad
that the pxoperty ownex is liable for the water line from the main to the premise. (Per
City code 402,06} I also hold the City of Fridley an.d/or its employees baimless for any
damages tbat may occur whil.e doing t�i.s operation. This to include,but not lim�ited to,
sod, yard,landscaping,trees,shru.bs,driveways,sidewalks�r the curb stop bax an.d
service line. i undersfan.d I am alsa requized to obtain a penmi�t prior to any woxk.
Nam.e: Address:
Phcme 1`Tumber: Date:
�ignature:
Witaess Signature:
FRiD�LEY CTI'Y COD�
CHAP'TE�i.402.WATER,STORM WATER AND 5.AIVITARY SEWEIt
ADMINYSTR.ATI�Oi�T
(RefClydNo 1i3,454,565,566,629,538,662,922,988, 1144,1156,1i91)
402.05. PERMTT FEE
Prior tQ coz�st�uctin.g or repair of any water or sewer line counectiug the existing munieipal system and any
house or bu�lding for which the agp3ica�tiQn is ma.de,the owner oz ca�tcaator shall be required to ob#a�m a
pe�an%t for such connection,and shall pay a.pennit fee as provided in Chsqate�'11 of this�ode. A�er such
connectian has been made,the Water and Sewer Department shall be notifie� It sh�ll be umlawful to cover
any cannectnag line untitil an inspection�ias been ma�.e and such co�ne�ti.an mid the wark incident thereto
has been app3roved by the City as a propez auc�s�ahle connecticm
402.06. REPAIRS AND 11�IAINT.�I�TANCE TO C�NNECTION
Ai�ar the initial connectian has besn made to the water servi.ce crtrb stop b�x ar the sew�r lead at the
properiy line or a water se.rvice or sewer lead has been e�tended ta the prvgerty line f�r caunectian,i�e
applicant,owner,or the occagant or user af such premises sh�ll be liable for all repairs re�uired to anY
wa�er lin:e and anp se�er lines necessary for c�n.ecti.on of the premises from t�.e mauu to t�.e pzemises. If
the properiy owner requests maintenance services ar zepairs be per,£ornaed by the City,the prop�i.y ownar
shall be charged for the costs of the maintenance and/or repairs,in.cluc�ng any necessary street repaias,at a
rate set annaally by a�.a�n+m���ve policy. It shall be fh.e responsibi3lity of tfiie applicant,Qwnar,occapant
or user to'perform sCandard maintenance of the sewer service liue�Sam i�ie pre�nises to the maroa mchiding
debris clearing or roat cutking and to maintain the watex serviice c�rb stop bo�for op�ab37.ity aud at snch
height as w'rll ens¢te t�ha.t it zenaains abave the fmislxed grac�.e afthe l�d ar propertp: (Ref 638,1156,I191j
City of Fridley � � �� �
Water Department
� 6431 University.Avenue NE � ��_ 13���l
Fridley,MN 55432
763-572-3566
1/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. t understand that the property owner is liabie for the water line from the main to the premise and all iMerior
plumbing. (Per City code 402.06) 1 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 vatves,piping,walls,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 READING(old meter) ������ �
Name• � � �N� Address ' �l' � �V
Phone Number � ��1'J�� Date `� �
$� ' ' Witness Signature .�T��_.."""-- ...
OLD METER# �✓ D I �
OLD READING�"17�Z��
NEW METER# �� ����� 1
NEW READfNG �
ERT# t�/!J�U" � J _`
' FRIDIEY CITY CODE
CHAPt'ER 4Q2.WATER,STORM WATER AN�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 connecting the existing municipal system and arry house or buiidiag for which the
appfication is made,the owner or contractor shail be required to obtain a permit for such 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 not�ed. it shail be unlawful to wver
arry connecting line untii an inspection has been made and such wnnection and the work incident thereto has been approved by the City as a
proper and witable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service iead has
been extended to the property fine for connection,the appficant,owner,or occupant or user of such premises shall be liabie for all repairs
required to any water line and sewer lines necessary for connection af the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the C'�ty,the property owner shali be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annuaNy by an administrative policy. 1t 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 inciuding debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wiN e�sure that it remains above the flnished
grade of the land or property. (Ref 638,1156,1191)