Meter Swap = Request Number: 12484
Pubflc works Division
Service Request
ProMem A�ddress: 7502 Tempo Ten Requested By: Patrick White
Department: WATER ��.eSg; 7502 Tempo Terr
Fridley,MN 55433
ProbiemlIss�: INSTALL AMR ME'lER Phone Number: 612-597-6746
Sched�iled Date: 2016-12-22 Schedaled'I��e: 07:U0:00
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ACIION NEEDED:I�tall AMR
Created by: Beth Kondrick Date Creaked: 2016-12-13
A(,'TiON TAI�N:
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St�us: Ia Pm�css Submitter H��een r,
Contactad
Date ComQleted: Completed by:
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City of Fridley
Water Department S�� I � � �
` 6431 University.Avenue NE
� Fridley, MN 55432 �j (��S�.(�j a.O-�)
�` 763-572-3566
�/+ae hereby authorize the City of Fridley and/or its employees to do wfiat is necessary to
repiace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all irKerior
plumbing. (Per City code 402.06j i also hold the C'rty of Fridley artdjiu employees harmless fw any damages that may occur white doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meterj Y �" l ���D -
Name• 1 ���"` w�� Address 1 ��Z , ���� �-Q-�r
Phone Numb r �o 12� � l, �� `� Date ��^ �� ' �
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�Signatur Witness Signature
OLD METER# � D �lJ���
OLD READING '�(J � ����
NEW METER# �� 4 l��� f
NEW READING v
_ ERT# �o !J � J 7�J
fRiDLEY CITY CODE
CHAPTER 402.WATER,S70RM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,92Z,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipat system and any/house or building for which the
application is made,the owner or coMractor shall be required to obtain a permit for such connectton,and shall pay a permit fee as provided in
Chapter 11 of this Code. After siach connection has been made,the Water and Sewer Department shatf be notlfied. it shall be unlawtui to cover
any connecting line until an inspection has been made and such connection and the work indde�t thereto has been approved by the�ty as a
prope�and suitabte wnnection.
402.06 REPAIRS AND MAlNTENANCE TO CONNEtTION
After the initial connection has been made to the water service curb stop box or the sewer tead at the properly 11ne or a water service lead has
been extended to the property line for wnnection,the applicarrt,owner,or occuparrt or user of wch premises shaii be liabie for all repairs
required ta any watec itne and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests mair�tenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maiMenance and/or
repairs.including�ecessary street repaiss at a rate set annual{y by an administrative poliry. ft shall be the responsibility aF the applicant,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including d�bris�learing or
root cutting and to maintain the water senrice curb stop box t'or operabitity and at such height as wi{{ensure that it remains ab�e ithefinished
grade of the land or property. (Ref 638,1156,1191) '`�
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