Meter Swap Request Number: 12435
Public works Division
Service Request
Problem Address: 7630 Van Buren St Requested By: Jill Dubay
Department: WA'IER ,�.�s; 7630 Vffi Buren St
Fridley,MN 55432
Problem/Issue: INSTAI.L AMR METER Phone Number: 612-208-78$7
3chedaled Dnte: 2016-12-15 Schednled Tlme: 08:00:00
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Crerted by; Beth Ko�rick Ihte Cre�ed: 2016-12-13
ACTION TAi�Nc
_ .�-1�.S�ct��� � ��,�Z
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St�aa: In Progress Snbmitter Ha�Been r
Cont�ted
Date Completed: �2,— I � � l� Completed by:
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City of Fridiey �� � �, ,� �
, Water Department
" 6431 University.Avenue NE ��������-�U ���"`
Fridley,MN 55432
763-572-3566
1/we �c�� �wh o+�y hereby authorize the City of Fridley and/or its employees to do what is necessary to
repiace 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 C'ity wde 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,pipin�walis,floors or the curb stop boz and service li�e. In understand 1 am also required
to obtain a permit prior to any work,if necessary.
FINAL METER READING(old meter) � v �� � 1 v
Name: �1 (' �u.�l�V Address /�J d U�{'1 �IJw`C fi� �
Phone Number — � � �.��� p� ��-"� 6 5� � l5+
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"�Signature � - ' Witness Signature„T�f�a
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OLD METER# 7 � �� 1� ��
OLD READING � V�L� ��l U
NEW METER#�I�� I Sd� ��
NEW READING a
ERT# lC9C�V� � 1 I� I
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 constructirrg or repair of any water of sewer line connecting the existing muniapal system and arry house or buildir�g for which the
application is made,the owner or coMractor shaii be required to obtain a permit for such connection,a�d shall pay a permit fee as provided in
Chapter 11 of this Code. After such co�nection has been made,the Water and Sewer Departmerrt shatt be notified. It shall be unlawful to oover
any connecting line until an inspection has been made and such connection and the work inadent thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water senrice curb stop box or the sewer lead at the property line a�a water service lead has
been extended to the property line for con�ed+ort,the applicant,ow+ter,or occuparrt or user of such premises sha11 be liab�for a!!repairs
required to any water line and sewer lines necessary for connedion of the premises from the main to the premises. If the property auner
requests mairrtenance service or repairs be performed by the City,the property owner shatt be charged for the costs of the maiMenance and/or
repairs,including necessary street repairs at a rate set annuaily by an administrative policy. R shall be the responsibility of the applic�nt,
owner,occupant or user to perform standard mai�rtenance of the sewer service line from the premises to the main lncluding debris ciearing or
root cutting and to mairrtain the water senrice curb stop box for operability and at such height as will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)