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Gn� AUTOMATIC METER READER
FRIDLEY
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Name .M��(.� ���{�TT
Date �"`� �� ��
Old Meter Number
Old Meter Reading `i
Replacement Na
Replacement Reading �
Replacement Make ��-�Es`�
ERT# .�,�`�.� ��
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its
empioyees 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 ail 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 nat limited to;valves,piping,wails,floars or the curb
� stop box and service line. I understand I am also required fio obtain a permit prior to any work,if
necessary.
Final meter readin old meter �� I �
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Name• Address• (/��Z1L/KJ /' �IL��
Phone Number. Date: ` 7��l�l�
Signature:
. Witness Signa re:
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)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the application is made,the owner or contractor shall be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter li of this Code. After such connection has been
made,the Water and Sewer Department shall be noti�ed. It shall 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 AND MAINTENANCE TO CONIVECTION
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 tiable 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 performed by the City,the property owner shall be 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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
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Request Number: 10277
Public Works Division
Service Request
Problem Address: 6320 Nionroe St Requested By: Sue Johnson-Utilities
Department: WATER Address: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: 2015-07-09 Scheduled'1"►me:
ACTION NEEDED:Final meter reading request at 6320 Monroe St NE closing date is 7/9/15 ERT#33302915
Created by: Julie Horak Date Created: 2015-07-08
ACTION TAI�N:
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...............................................................................................:.............................._._....................................._.............................................................................................................._.........__.__.___..................._._........._........._......_......._....._.._..__
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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