Meter Swap ,� ? �� � -.
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v.�� AUTOMATIC METER READER
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Name �`�� J�����
Date �-----�'�"��'� ` _ .�—.-
Old Meter Number � ��1 l
Old Meter Reading �9 �
Replacement Na - � ��A�S��K
Replacement Reading �
Replacement Make ��.�'�
ERT# ���C� ��� t v ,
Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-35b6
I/we hereby autharize 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 tiabfe for the water line fram the main ta the premise and all interior plumbing. (Per City code
402.06j 1 aiso hold the City of Fridley and/its employees harmless for any damages that m�y occur
while doing this operation. This to include,but not(imited to;valves,piping,walls,floars 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�
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Name: Address:_, �L` �� �;'`��
Phone Number: Date: �� �� � •
Signature: `�C�
Witness Signature:
FRlDLEY 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 mun+cipa!system and anj+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 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 wark incident thereto has been approved by the City as a
proper and suitable connection.
4�2.06. REPAIRS AND MAINTENANCE TO C�NNECTION
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 senrice or sewer lead has been extended to the property line for connection,the applicant,owner,
or the occupant or user of such premises shal!be liable for all repairs required to any water line and sewer lines
necessary for connection of the prernises from the main to the premises. If the property owner requests
maintenance service or repairs be perFormed by the City,the property owner shall he charged for the costs of the
maintenance andJor repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. It shall be the responsibility of the applicant,owner,occupant or uset to perform standard maintenance af
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 operahility and at such height as will ensure that it remains above the finished
grade of the(and or property. (Ref 638,1156, 1191)
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Request Number: 9881
Public Works Division
5ervice Request `
Problem Address: 6437 Baker A�NE Requested By: 5ue Johnson-City Utility Depaztment
Department: WATER Address: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: 2015-03-24 Scheduled Time:
ACTION NEEDED:Please do a final meter reading on 3/24/15 at: 6437 Baker Avenue NE ERT#33302591 Closing
date is 3/24/15
Created by: Cheryl Pellegrin Date Created: 2015-03-20
ACTION TAKEN:
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Status: In Progress Resident Contacted O
Date Completed: Completed by:
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