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City of Fridley
Aater Deuartment
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Name ���� � �2� SeCf
Date � -'�""•� �
Old Meter Number ` ��_
Old Meter Reading U � � ��..�r�
Replacement No. 3 u J V �
Replacement Reading
Replacement Make � Q, Q e�
Remarks•
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� �J'' INSTALLATION
G7YOF AUTOMATIC METER READER
FRIDLEY
Address VJ��� '' �T�'�(
Name ����"T �t )2�,LL
Date �''�`�
Old Meter Number � �
Old Meter Reading ` �
Replacement No. ��� ��
Replacement Reading �
Replacement Make �v L�,
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Replacement ERT#
Remarks:
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City of Fridley
Water Department
6431 Uni�ersity Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City af 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 to the premise and all interior plumbing. (Per Gty 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 include,but not limited to;valves,piping,walls,floors or the curb
� stop box and service line. I understand 1 am also required to obtain a permit prior to any work,if
necessary.
Pinal meter reading(old meter) �� 1 ��
Name: Address: �`J�J ` �� � �T
Phone Number: ate: �J 1����
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Signature:
. Witness Signature: '"�"C
FRIDLEY CITY C�DE
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.Q5. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the appiication is made,the owner or contractor shall be required to obtain a permit for such
connection,and shall pay a permit fee as p�ovided in Chapter 11 af this Code. After such connection has been
made,the Water and Sewer Department shall be nati�ed. 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.
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 ati repa+rs 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 necessary st�eet repairs,at a rate set annually by an administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to pe�form 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 uf the land or property. (Ref 638,1156,1191)
Request Number: 9669
Public Works Division
Service Request
Problem Address: 6331 7th St Requested By: Jason wBonfe's Plumbing
Department: WATER Address: No address provided
Problem/Issue: 1URN WATER ON/OFF Phone Number: 612-919-3397
Scheduled Date: 2015-01-07 Schednled Tlme: 01:00:00
ACTION NEEDED:11zrn off water for repair.Permit inprocess.****$ILL****
Created by: WendyHiatt Date Created: 2015-01-07
ACTION TAI�N:
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Status: in Progress Resident Contacted C7
Date Completed: Completed by:
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