Meter Swap '� ��1��?�,�''-�lij�"t.rc%`
� �,.�--�� INSTALLATION
�.�� AUTOMATIC METER READER
FRIDLEY
Address C>` ��c.-1 L� �
Name �'V/�� l,�C���,�
Date ����" �O�
Old Meter Number � ��� ���a
Old Meter Reading � 5�
Replacement No. ��M� � ��`l
Replacement Reading C�
Repiacement Make �+��
ERT# ��J� ��40�(� �/
Replacement ERT#
Remarks:
��` Signed:
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Ad�= 8$1 �la€IRE I./�iK'E D�11M . 7�3�74-2�'53
Sct�d�+e: 6�13/'It�12�'1tk30 AM �. ��.
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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 all 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 not limited to;valves,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) ���� ��O
Name: Address: �V \ y..��Q�� L"(C '`��
Phone Number: Date: 1�r�� -
Signature:
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SAN[TARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144,1156, 1191)
402.05. PERMIT FEE
Prior#o constructing or repair of any water or sewer line connecting the existing municipal system and anq house
or building for which the apptication is made,the owner or contractar shall be required to obtain a perrnit for such
connection,and shali 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 6een 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 1ia61e for all repairs required to any water line and sewer lines
necessary for connection of the prernises from the main ta 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 annualty by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewe�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 ofthe land or property. (Ref 638,1156,1191)
!
t��
Request Number: 10171
Public Works Division
Service Request
Problem Address: 881 W Moore Lake Dr Requested By: Ryan
Department: WATER Address: No address provided
Problem/Issue: TURN WATER ON/OF'F Phone Number: 612-298-8995
Scheduled Date: 2015-06-08 Scheduled'Iime: 12:45:00
ACTION NEEDED:Turn off water for repair. ****BII.L***
Created by: Wendy Hiatt Date Created: 2015-06-08
ACTION TAI�N:
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.
,
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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