Meter Swap �
� Request Number: 12525
Public Works Division
Service Request
Problem Address: 7686 Van Buren St Requested By: Gail Rouffe
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Namber: 612-710•Z465
Scheduled Da • 2016-12-30 � Sc6ednled 1lme: 07:OO:Of1
j � V�/
ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2016-12-ZO
ACIION TAi�N:
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Statua: In Progress 5nbmitter Ii�Beee r,
Coutacted
Date Completed: '��,� 3(� �l� Completed by:
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City of Er+dley r -, �j� �
,� Water Department ��"� ( +�
6431 University Avenue NE
r Fridley, MN 55432 � �(v-�S a-������
763-572-3566
�/We hereby authorize the City of Fridley and/or its emp�oyees 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 interior
plumbing. (Per City code 402.06) I also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box aod service line. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FlNAL METER READIN6(old meter) `� v �" "' � �
Name: V10.v f �lJl'1 l- � Address �lY �� �U•h ���"'�� �
Phone Number �ti?— �(V '�� lfJ� Date �� _ �� —� �
�Signature �� Witness Signature
OLD METER# � I � t 1 "` ��
OLD READING I, 1`7 ( � v/ -l �✓
NEW METER# � l / � I v� � �
NEW READING �
ERT# � ag� � � 1 � .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMINISTRATION
(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 af sewer line connectir�g the existing municipai system and arry haase or building for which the
application is made,the owner or coMractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided irr
Chapter 11 of this Code. After wch connection has been made,the Water and Sewer Department shall be notified. k shali be unlawful to co�r
any connecting line urrtil an inspection has been made and wch connection and the worlc indderrt thereto has been appro�red by the City as a
proper and suitable connection.
402.06 REPAtRS AND MA{NTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has
been extended to the property line for wnnection,the appiicant,owner,or occuparrt or user of wch premises shall be liabie for all 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 maintenance service or repairs be pe�fiormed br the City,the property owner shall be charged for the costs of the maintenar�e and/or
repairs,incfuding necessary street repairs at a rate set annually by an administrative poliry. It shail be the responsibility of the applicant,
owner,occupant or user to perform standard mairitenance of the sewer service line from the premises to the main indudirig debris dearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remair�above the finished
grade of the land or property. (Ref 638,1156,1191)