Meter Swap V Request Number: 12444
Public Works Division
Service Request
Problem Address: 7374 Van Buren St Requested By: Bobbi
Department: WA1ER Addreas: No address provided
Problem/Issue: INSTALL AMR METER Phone Nnmber: 7b3-242-0271
5cheduledDate: 20 6-12-IS Sc6ednledTfine: 07:00:00
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ACIION NEEDED:AMIt
Created by: Weidy Hiatt Date Crested: 2016-12-14
ACTION TAKEN: �
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Status: in Progress 5nbmitter Hs�Beee �..
Coutncted
Ds�te Completed: Completed by:
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City of Fridley S� �� � 1
Water Department
6431 University.Avenue NE � � ,v--`-� ��-����'�
� Fridley,MN 55432
753-572-3566
�/We hereby authorize the City of Friclley and/or its employees to do what is necessary to
replace the water meter. t 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) t a4so hold the C'�ty af Fridley and/its employees harmless for any dama�es that may ocwr while doing this
operation. This to include,but not limited to valves,piping,walis,floors or the curh stop boz and service line. tn understand 1 arst aiso required
to obtain a permit prio�to any work,if oecessary.
FINAL METER READHYG(old meter) �� �� � � �
Name• ��' �v� Address ` � ` �� ��
Phone Num � � � ��� Date ��^ � " ^ `
� Signature Witness Signature " �-�'— ` �
OLD METER# I t� J � I � �' Z
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OLD READING ��-4 I �7�
NEW METER#_� ` G { ��i_1�
NEW READING (/
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FRfDLEY CITY CODE
CHAPTER 402.WATER,570RM WATER AND SANITARY SEWER
ADMfAifSfRATi0A1
(Ref Qrd No 113,464,565,566,629,638,562,922,988,1144,1156,1191j
402.5 PERMIT FEE
Prior to constructing or repair of any water of sewer line connecting the existing municipal system and arry house or building for which the
application is macle,the owner or corrtractor shafl be required to obtain a permit for such connection,and shall pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Watec and Sewes Department shaii be not�ed. it shait be unlawful to cover
any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
402.06 REPAIRS ANQ MAINTENAAICE TO COTIAIECTiON
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 connection,the applicant,owner,or accuparrt or user of wch premfses shall be liable for all repairs
required to any water line and sewer tines necessary fior connection of the premises from the main to the premises. If the property owner
requests maintenance service or repairs be performed by the C'�ty,the property owner shafl be charged for the costs of the maintenance and/or
repairs,inciuding necessary street repairs at a rate set annuaily by an administrative poliry. It shall he the responsibit'ity of the applicant,
ow�er,occupar�t or user to perform standard mairrtenance of the sewer senrice line from the premises to the main includir�g debris clearing or
root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains a6ove the finished
grade of the land ur property. (Ref 638,1156,1191)