Meter Swap . Request Numb►er: 12936
Public Works Division
Service Request
Problem Address: 7419 University Ave Requested By: A�y
Departme�: WATER Address: No address provided
Problem/Isaue: INSTALL AMR METER Phone Number: 651-336-2672
Scheduled Date: 2017-01-24 Schednled 11me: 11:00:00
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ACfION NEEDED:
Created by: Beth Kondrick Date Cre�ed: 2017-01-18
ACTION TAI�N:
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Status: In Progress Sabmitter Has Beea �..,
Contscted
Uate Completed: Completed by:
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iAfafier�e�artrrtent �� ;� L �:( '
5431 i�niversit�/Avenue NE 4�
Fridley,MN 55432 �/(,� --��/�°�(��' F
. � 763-572-3566
��"v� hereby authorize the City af Fridley and/or its emp{oyees#o slo wfiat is necessary to
replace#he water�neter. 1 understand that the property owner is liable for the water line from the main to the premise and all interiar
ptu�nbing. (Per City code 402.06) i also hold the City of Fridley and/ifis empioyees harmless for any damages that may occur while doing this
operation. This to#nctude,but not limi#ed to valves,piping,walis,flooe�s or the curb stop box and service line. in understand!am also require�
to obtain a permit prior to arry worRc,if necessary.
FINAL METER READIN6(ald meter) � � �V �
Name: Address� �6 V W�
Phone Wumber���� �rp� j�^f� t+ Lgate_�r �^�� l,�
Signature Witness Signature
OLD METER# ' � � � �� �
OLD READtNG� y C� � ZC�C�
NEW METER# _1����� VL/�
NEW READlPtG �
ERT# dl/6/l�J d] �JU 1.,�
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
�Ref Orci Mo Z13,464,565,566,629,638,662,922,988,1144,i156,1191}
402.5 PERMtT FEE
Prior to constructing or repair of any water of sewer line connecting the existing muniapal system and any hause or buldirig for rrhich the
appiication is made,the owner or cormactor shail be required to obtain a permit for such coanectioa,and shall pay a permit fee as provided in�
Chapter 12 of this Code. After such connection has been made,the Water and Sewer Departmerrt shall be not�fied. tt shail be un(awfui to cover
any zonnecting line urrtif an inspection has been made and such connection and the work inciderrt thereto has been appr�ved by the Cdy as a
proper and suitab{e conn�ction.
402.06 REPAIRS AND MAINTEP1AItiCE TO CONNECTION
After the initial connecfiort has been made to the water service curb stop box or the sewer lead at the property lirte or a water service lead has
been extended to the property line for connection,the appiiprrt,owner,or accuparrt or nser of such premises shaq be liabie for all repairs
required to any water{ine and sewer lines necessary for connection of the premises from the main to the premises. if the property�vner
requests main#enance serxice or repairs be perFosmed by the Gty,tfie property owner shati be charged for the costs of the mairrtenance and/or
repairs,includi�g necessary street repairs at a rate set annuaily by an administrative policy. It shafl be the responsibitity o#the applicanC,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main i�ctuding debris dearing or
roofi cutting and to maintain#he wrater service curb stop box for operability and at such height as will ensure that tt remains above the finished
grade af the land or property. (Refi 638,1156,1191)