Meter Swap �� Request Number: 12439
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PO�1C wOl'kS DIV1SlOri
Service Request
Problem Address: ?470 Van Buren St Requested By: David Jahnson
Departmeirt: WATER Address: 7470 Van Buren St
Fridley,MN 55432
Problem/Issee: INSTALL AMR METER Phone Namber: 763-7847447
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'��Scheduled Date: 2017-01-27 Scheduled 1lme: 01:OO:OQ
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ACiTON NEEDED:Install AMR
Created by: Beth Kondrick Date Cre�ed: 2016-12-13
AL.'lION TAKEN: .
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City of Fridley c�� /� /��
Water Department � ` � ''J� �C��`'V ''� �
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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. 1 understand that the property 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'm/of Fridley and/its employees harmiess for any damages that may occur while doing this
operation. This to include,but not limited to vaives,piping,walls,floors or the curb stop boz and service line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL M READING(oM meter) ___�I �C!�.J `5�
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Name• �/w `(.J► ����,�L Address �
Phone Number N(J�^ , V� � i f Date `���� ��
Signature ` Witness Signature
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OLD READING .E/�J� � �
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NEW METER# `� �
NEW READING C�
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FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATI�N
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair o�f any water of sewer line connecting the existing municipal system and arry house or butidir�for which the
application is made,the owner or contractor shali 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(fPed. It shall be unlawful to c�ver
any co�necting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNEC770N
After the initial connection has been made to the water service curb stop box or the sewer lead at the property Iine or a water service lead has
been eutended to the property line for connection,the appiicant,owner,or occuparrt or user of such premises shall be liable for atl repairs
required to any water line and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests mairrtenance se►vice or repairs be perFormed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative poliry. It shali be the responsibility aF the appiicarrt,
owner,occuparrt or user to perform standard mairrtenance of the sewer service line from the premises to the main induding debris dearing or
root cutting and to maintain the water service curb stop box fo�operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j