Meter Swap r
• Request Number: 12419
Public works Division
Service Req�st
Problem Address: 75Q0 Van Buren St Requested By: Jea�mie Asscidt
Depirtment: WA'IER Addreas: No ad�esa providcd
Problem/Issne: INSTALL AMR METER Pho�Number: ?63-242-663�
Schednl te: 016-12 Schedalei T1�: 07:00:00
�� � C..'lJ Y 1
ACITON NEEDED:AMIt
Cre�ed by: Wendy Hiatt Date Cre�e�: 2016-12-12
AC'IiON TAI�N:
� �� I � Z
5tat�: In Progress 5abmitter Hiu Been �.
�onheted
D�e Con�leted: l 2 _... � �...�1� Completed hy:
.-�������� '
,y� �
City of Fridley f � � �
Water Department �� i ' '
, � 6431 Universiiy Avenue NE
' Fridiey,MN 55432 � 1 �v'S�-���
763-572-3566
I/we �i����v►j�t ��`i5t"� �� hereby authorize the City of Fridley andjor its esnployees 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 aod all irrterior
p{umbing. {Per City code 402.06) i also hold the City of Fridley and/its employees harmiess 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 box and service line. In understand 1 am also required
to ohtain a permit prior to any work,if necessary.
F{WAL ME'i'ER READIAfG(old meterj �� ` 1 � v/
Name• ���N/�4� �r7 L� �f!� Address /7GV �1��, 1���-� 5"�'
PhoneNumber ��� 2�Z�'1��63� Date t�—� -`—��
� Signature �iness Signature ��`Y�n'�
/ \
OLD METER# ` � ��� 7 I U
OLD READtNG 1 � � 1 �G�
NEW METER# � 6 �I U3��
NEW READING C�
ERT# �.5������ �Z
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINIST{tATiON
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting tfie existing municipal system and arry house or buildir�for whitfi the
application is made,the owner or contractor shali be�equired to obtain a permit for such connection,and shail pay a permit fee as pro�Ided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerrt shail be notified. It shall be unlawful to�ver
any connecting line until an inspection has been made and such connettion and the work incident thereto has been approved by the City as a
proper and suitable wnnection.
402.06 REPAIRS ANn MAINTENANCE TO COAINECTiO'N
After the initiaf connection has been made to the water service aarb stop box or the sewer tead at the property line w�a water seevice lesd has
besn extended to the property line fior connection,the appiicant,owner,or occuparrt ar user of wch premises shall be IiaWe for atl repairs
required to any water line and sewer lines necessary for connection of the premises from tfie main to the premises. ffi the property owner
requests maintenance service or repairs be performed by the City,the property owner shal{be charged for the costs of the maiMenance andJor
repairs.including�ecessary street repairs at a rate s+et annually by an administrative poliry. It shall be tfie responsibility of the appiicaM,
owner,occupant or user to perform standard maintenance of the sewer service line from the premises to Che rnain including debris dea�ing or
root cutting and to maintain the water senrice curb stop box for operability and at such height as will ensure that tt remains above the flnished
grade of the tand or properry. (Ref 638,1156,1191)