Meter Swap �-----------_ _
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City of Fridley
Water Department
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. Address (�U � �'� �DOY�G � N� , _
.. Name � � __
Date (�" a�-"_ —(�`�
Old Meter Number / 0 ���� ��
Old Meter Reading �- �
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' Replacement No.
Replacement Reading �
� Replacement Make � � �
Remarks• s�o
Signed
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� �1�' `� INSTALLATION
G.N� AUTOMATIC METER READER
FRIDLEY
Address � �.c: `�
Name c�,� ,�, �..�
Date �11--��
Old Meter Number `l, �
Old Meter Reading �
Replacement Na — `�
Repiacement Reading �
Repiacement Make�(_,�,
ERT# � ��C� ����
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
fi431 University Avenue NE
Fridiey, MN 55432
(763)572-3566
I/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 liabie for the water line fram the main to the premise and all interior plumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may oaur
while doing this operation. This to include,hut not limited to;valves,piping,walls,floors or the curb
stap box and service line. I understand I am also required to obtain a permit prior ta any work,if
necessary.
Final meter reading(old meter) � � �� � �O
Name: Address: �� ```�� � ��—
Phone Number: Date: IC��' ��
Signature:
. Witness Signature:
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FRIDLEY CtTY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,fi29,638,662,922,988, 1144, 1156, 1191)
402.05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and anjr house
or building for which the application is made,the owner or contractor shall be required to obtain a permit 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 sha{I 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 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 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 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�ecessary 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 will ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191j
Request Number: 7617
Public Works Division
Service Request
Probfem Address: 880 W Moore Lake Dr Requested By: Beverly Sampson
Department: WATER Address: No address provided
Prob�mllssue: LEAKING METER Phone Number: 880 W Moore Lake Dr
Scheduled Date: 2014-03-06 Scheduled Time:
AC710N NEEDED:Water meter is leaking and flooding her basement
Created by: Wendy Hiatt Date Created: 201403-06
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Comple#ed: Completed by:
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