Meter Swap �`��iNSTALLATION��� 3J
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c�.N� AUTOMATIC METER READER
FRIDLEY
Address . �(, �ti-'�'e
Name ������ �r�Q1-�
Date�" i�.s' � _
Old Meter Number (,��
Old Meter Reading � � ��
Replacement No. �������-�CS�)Y
ReplacementReading �
Replacement Make
ERT# ���7`J'� � �
Replacement ERT#
Remarks:
-.��,�� Signed:
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a �ii�yy t�f Fr�dl�y
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
i/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to replace the water meter. I uncierstand that the property owner
is liable for the water line fram the main ta the premise and all interior piumbing. (Per City code
4U2.06} I aiso hold the City of Fridley andJits employees harmless for any damages that may occur
while doing this operation. This to include,hut not limited to;vaives,piping,walls,floors or the curb
� stop box and service line. I understand i am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) �l �
Name• Address• ;' .�"7`� �' `���� —
Phone Number: Date: � �'"�1� •
.-
Signature:
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STURM WATER,AND SAMTARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,624,638,662,922,488,1144,5156, 1191)
402.05.PERMtT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any hause
or building for which the application is made,the owner or contractor shall be requi�ed 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 Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until an
inspection has heen made and such connection and the work incident 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 service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all�epairs required to any wate�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 perFormed by the City,the property owner shall 6e charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water service curb stop box for operability and at such height as wi({ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
Request Number: 5978
Public Works Division
Service Request
Problem A�ddress: 6321 Monroe St Requested By: Richard Lombard
Department; WATER Address: No address provided
Problemllssue: LEAKING METER(WATER) Phone Number: 763-571-2261
Scheduled Date: 2013-04-08 Scheduled Time:
ACTION NEEDED: Check leaky meter
Created by: Wendy Hiatt Date Created: 2013-04-08
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: � ��_ �� Completed by:
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