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FRIDLEY
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Date�-��
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Old Meter Reading 0 9.��
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Replacement Reading �
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Replacement ERT#
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j - 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 water meter. I understand that the property owner
is liable for the water line from the main ta the premise and all interior plumbing. (Per City code
402.06) I also hoid the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. This to inciude,hut not limited to;valves,piping,wails,fioors or the curb
� stap box and service line. 1 understand I am also required to obtain a permit prior to any work,if
necessary.
Final meter readin otd meter) ���a ��O
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Name: Address: � 7�
Phone Number: Date: �`��" �� �
Signature:
. Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADIIAINISTRATION
(Ref Ord Na 113,464,565,566,629,638,66Z,922,488,1144,1156, 1291)
402.05. PERMlT FFE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owne�or contractor shall be required to obtain a Permit for such
cannection,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 been made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
442.06. REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer fead at the prnperty
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 6e 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/ar repairs, including any necessary street repairs,at a rate set annuatly by an administ�ative
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 aperability and at such height as will ensure that it remains above the finished
g�ade of the land or property. (Ref 638,1156,1191)
.
Request Number: 6117
Public Works Division
Service Request
Problem A�ddress: 6370 Van Buren Requested By: Sandi Hara
Department: WATER �ldress: No address provided
Problemllssae: READ METER(WATER) Phone Number:
Scheduled Date: Scheduled Time:
ACTION NEEDED: Final meter reading. ERT#33303043 Closing on 5/10/13
Created by: Wendy Hiatt Date Created: 2013-05-06
ACTION TAKEN:
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Status: ln Progress Resident Contacted �
Date Complefed: Completed by:
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Hiai�, Wendy
From: Hara, Sandra
Sent: Monday, May 06, 2013 10:04 AM
To: Hiatt, Wendy
Subject: Final Meter reading
Hi
I need the guys to scan an AMR for a final meter reading on 5/10/13 at 6370 Van Buren St NE. The ERT#is 33303043.
Thanks.
Also can you call me when you have a chance?
Sandi Hara
City of Fridley
Utility Billing
763-572-3529
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