Meter Swap � Request Number: 12735
Public Works Division
Service Request
Problem Address: 7441 Van Buren St Requeated By: Da�I.ee
Departmeut: WATER Addeesa: No ad�ess ptovided
Problem/Isaue: INSTALL AMR METER Phone Number: 763-785-Z926
Se�edal d Date: 201 -01-18 � Sc�eduled Tlme: �
� l '
AGTION NEEDED:
Created by: Wendy Hiatt Date Cre�keds 201?-01-0�
ACTTON TAKEN•
1��.
Statua: In Progress Snbmitter Has Bece �
Coututed
Date Completed: Completed by:
Honrs
1 - ���" +�
u�/�r r�rsa9ey
Water�epartrnent
6431 Universit�r!#venue NE ��p��v�1 /
- Fridley, MN 55432 �1(0 -'� ��
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� 763-572-3565 ��� '1
. � p•..
►/+Ne hereby authori2e the City of Fridiey and/or its esnp oyees to do wfiat is necessary to
replace the water meter. 1 understand that the property owner is{iabie for the water line from the main to the premise and all interior
plumbing. �Per City sode 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur white doing this
operation. This to include,but not Bimited to valves,piping,wails,floors or xhe curb stop box and service line. in understand(am also required
to obtaia a permit pr�or to arry work,if necessary.
FIAIAL METER READING joid meter�
� �1� i � �
Name: �b131.3 G! �c Address � ►`� � \� �����•�
Phone Num p� � '"�,�'" �.�
Signatare '�.• - W�tness Signature
OLD METER# ���� / ��V
OLD READtNG__ 10 ���I�b
NEW METER# ��I � l Uo��
N�W REQDING �
ERT# �/,1 V l�U �� -1 g
FRIDLEY C{TY CODE
CHAPTER 4Q2.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord iYo 113,464,565,566,623,638,662,922,988,1144,1I56,1191]
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipa(system and arry house or buiiding for which the
application is made,the owner or corrtractor shati be required to obtain a permit for such co�r�ection,and s[�alt pay a perm�t fee as provided in�
Chapter 12 of this Code. After such connection has been made,the Water and Sewer Department sha0 be notiFied. It shaU be untavrfui to cover
any connecting line untii an inspection has been anade and such connectio�and tha worlc inciderrt thereto has been approved by the City as a
proper and suitable connection.
402,06 REPAIRS AND MAN1dTTENANCE TO CONNECTION
After the initiat connection has been made to the water service curb stop box or tfie sewer tead at the property line or a water senrice lead has
been extended to the property fine for connectlon,the appiicant,owner,or accupacrt or user of such premises shall be liabie for elt repairs
required to any water Itne and sewer lines necessary for connection of#he premises from the main to the premises. ff the properly a�mer
requests mairitenance service or repairs be perFormed by the City,the psoperCy owner shail be charged for the costs of the mairrtenance and(ur
repairs,including necessary street repairs at a rate set annually by an administrafiive�olicy. It shall be ti�e cespoosibility of the appiicarrt,
owner,occupant or user to perForm standard mairrtenancs of the sewer service line from the premises to the main including debris cieartng or
root cutting and to maintain the water service curb stop box for operability and at such height as wi41 ensure that it remains above the finished
grade of#he land or property. (Ref 638,1156,1191�