Meter Swap �� �c�>���%�-�?�i�-��
� (J�'��� INSTALLATION �
G7YOF AUTOMATIC METER READER
FRIDLEY
Address �"�•71 ����
Name �--.�(i�i.1 �1�C�i`�
Date <)-�.�'���
Old Meter Number � �a'�
OldMeterReading �! 6��
Replacement No. � fZPrS
Replacement Reading �
Replacement Make ���'��
ERT# ����,� '"T�
Replacement ERT#
Remarks:
`-�,� Signed:
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i�a��nt: YUat�s ��e: �-71'��
Ad�� 6�i� S7'� {:abadc. . �-7743
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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
employees to do what is necessary to replace the wate�meter. I understand that the property owner
is liable for the water line from the main ta the premise and al(interior plumbing. (Per City code
402.06) I a(so hold the Gty of Fridley and/its employees harmless for any damages that may occur
while daing this operation. This to inciude,6ut not limited to;valves.piping,walls,fioors or the cu�6
� stop 6ox and service line. I understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter reading(old meter) � . �" "
Name: Address: ��/ ,1 �-��C�
Phane Number: Date: � ��� - •
Signatu .
_ Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANII'ARY SEWER
ADMINISTRATICIN
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156,1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line co�necting the existing municipal system and any house
or buildi�g for which the application is made,the owner or contractor shafl be required to obtain a permit for such
connection,and shail 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 shail 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 Gty as a
proper and suitable connection.
4Q2.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initlal 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 repairs required to any water line and sewer lines
necessary for connection of the premises from the main to the premises. If the property awner requests
maintenance service or repairs be performed by the City,the property owner shali be charged for the costs of the
maintenance and/ar repairs, including any necessary street repairs,at a rate set annually by an administrative
po(icy. 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 wilt ensure that it remains above the finished
grade of the land or praperty. (Ref 638,1156,1191j .
� Request Number: 11093
Public Works Division
Service Request
Problem Address: 6431 Jackson St Requested By: Sue-Utility Billing
Department: WATER Address: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: Scheduled Time:
ACTION NEEDED:Final reading.Clo ng 1/27/16 E 33302744
Created by: Wendy Hiatt Date Created: 2016-01-08
ACTION TAKEN:
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.................:.......:...:................ .........�..�..�...-..:......._....._�:�.�.�.�......................................................................:.............:....:.._...._.....__...._....................__...._....._.....:.............._......_...__._.___
...................................................................................:.......................................:................................................................................................................................................................................................._._......................................_____...................
..........................................:.........:......................................._...:...........:................_....._........................................................................................._......................:............._.......................:....................._._........................_......................_......................__...._..
_.......................................................................................:..............._...............�........................_....................................._.................................................._.........................................__......._.......:_............................_.............._............................_._........_........
..................................................................................................................................................................................................................................................................................................................................................................._....___................._.........
Status: In Progress Resident Contacted C"
Date Completed: Completed by:
��a�����
"Hiatt, Wendy
From: Johnson, Susan E.
Sent: Friday, January 08, 2016 9:09 AM
To: Hiatt, Wendy
Subject: Final Meter Reading
Final Meter Reading request:
6431 Jackson St. NE
Closing date: 1/27/16
Ert#33302744
Thank you!
Sue�oA�noan
City of Fridley
Utility Billing
763-572-3529
My office hours.
Tuesday,Thursday& Friday
8am-4:30pm
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