Meter Swap Request Number: 12606
Public works Division
Service Request
Problem Addreas: 75�0 Van Buren St Requested By: Domimc
Departme�: WA'IER Addresa: No ad�ess provickd
Problem/Isaue: INSTALL AMR METER Phone Nnmber: I-740-602-2550
Schednied Date: 2017�01- Scheduled 11me: 10:00:00
ACIION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2016-12-28
ACTION TAI�N:
����,. �t,� _____
St�us: In Progress Sn6mitter Hu Been r,
Contacted
D�e Completed: �-- s�— �� Completed by:
Hoars C�
�
City of Fridley � I �
Water Department (� l,p �
• 6431 University Avenue NE i
` Fridley, MN 55432 ������� � �v�
• 763-5723566
I/we hereby authorize the City of Fridley and/or its employees to do what is necessary to
replace the water meter. i understand that the property owner is liable for the water line from the main to the premise and all irrterior
plumbing. (Per City code 402.06) I also hold the C'ity of Fridley and/its empioyees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walls,floors or the curb stop boz and senrice line. In understand I am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) �/ 1 � l:���
Name: �d'�`^'�N�C� Address / ��V ��, �j�M�✓`�G.vti- �...
Phone Number� 7�V� ��2- "27 J� pate � ✓ �— ��
�Signature - Witness 5ignature
OLD METER# I �� �� � I�I
OLD READING b��S ✓��
NEW METER# �� � l V� ��
NEW READING�
ERT# �� �� � ° 1 t � �
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,b38,662,922,988,1144,1156,1191j
402.5 PERMR FEE
Prior to construding or repair ot any water of sewer line connecting the existing municipal system and arry house or buildir�for which the
appiication is made,the owner or corrtractor shall be required to obtain a permit for wch connection,ancl shall pay a y�rmit fee as provided in-
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmer�t shall be notified. It shall be unlawFul to cvver
any connecting line uMil an inspection has been made and such connection and the work incideM thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection hais been made to the water service curb stop box or the sewer lead at the property line or a water seMce lead has
been extended to the property line for connecfion,the appiicant,owner,or occupaM or user of such premises shall be liabie for all repairs
required to any water fine and sewer lines necessary for connection of the premises from the main to the premises. if the property owner
requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or
repairs,including necessary street repairs at a rate set annually by an administrative poliry. R shali be the responsibility of the applicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or
root cutting and to maintain the water service curb stop box for operability end at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)