Meter Swap Request Number: 12492
' ` Public Works I�vision
� Service Request
Problem Address: 7301 Van Buren St Reqnested By: Lyim A�
Depxrtmeut: WATER Addresa: No.address ptovicie;d
Problemllaaue: INSTALL AMR METER Phoae Number: 612-814-1917
Schedaled te: 1 12-21 S� Sc6eduled 11me: 11:00:00
�P C � �,
ACIION NEEDED:
GYeated by: Wendy Hiatt 1hRe Cte�ed: 2016-12-16
ACII N T �
Q A►��EN�����.%
C�,�
St�ua: In P'rogress Sabmftter H�Been �..
Contuted
Dxte Completed: Compieted by:
� �
� �� Z� r � �
City of Fridley �'
Water Department � �l � � '� '�
6431 University Avenue NE `� S�7����
Fridiey, MN 55432 ) �� �
� , 763-572-3566
.
�l�e hereby authorize the City of Friclley andjor its empl�yees to do what is necessary to
replace the water meter. !understand that the property owner is liabfe for the water line from the main to the premise aod a{I interior
plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
ape�ation. This to 4nclude,but not limited to valves,piping,walls,floors or the curb stop box and service line. fn understand i am aiso required
to obtain a permit prior to a�y work,if necessary.
FIIVAL METER READING(old meter)_ _ _r`-' 1 �` '� "�
Name: i��� Address �
�/}�� j� { ^7 `Z� `
Phone Number i�l��� !�" ►�t 1 Date ` �' 1 �
/`► �„-.,___......,:,.....,�
Signatuce------�•°•°�----•--•---�, �� Witness Signature .
OLD METER# `����� J�
OLD READING �d���7(JV
NEW METER# �� � ` �� VV
NEW READtNG �
ERT# .Y� Y��
FRIDLEY C{TY CODE
CHAPTER 402.WATER,STORM WATER AAiD SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,4&4,555,566,6Z9,638,662,922,988,1144,1156,1191�
402.5 PERMIT FEE
Prior to constructing or repair of any water of s,ewer line connecting the existing municipal system and arry house or building for which the
appiication is made,the owner or wntrector shall be required to obtain a permit for such connection,and shali pay a permit fee as provided in
Chapter 11 of this Code. After such connedion has been made,the Water and Sewer Qepartment shati be noti�ed. It shafl be unlawful to cover
any connecting line until an inspection has been made and such connection and the wo�lc incident thereto has been approued by the City as a
proper and suitabie connection.
402.06 REPAIRS AND MAIN7ENANCE TO CONNECTION
After the initial connection fias been made to the water servfce curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property ttne for connection,the appiiprrt,owner,or occupant or user of wch premises shal!be liable for all repairs
required to arry water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner
requests mairrtenance service or repairs be performed by the City,the property owner shati be charged for the casts oi tfie mairrtenarrce and/or
repairs,including necessary st�eet repairs at a rate set annuaNy by an administrative potiry. It sMali be the responsibility of the applic,ant,
owner,occupam or user to perform standard mairrtenance of the sewer service{ine from the premises to the main indudir�debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as wili ensure thaC it remains above the finished
grade of the land or property. (Ref 638,1156,1191)