Meter Swap '� �l-�� i ����«-��� ��
INSTALLATION
G.nroF AUTOMATIC METER READER
FRIDLEX
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Name�s .t�1� ��''��
Date �� � �
Old Meter Number �� «���
Old Meter Reading �� �
Repiacement No. l �
Replacement Reading �
Replacement Make � �
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Replacement ERT# �
Remarks � �
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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
empfoyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line from the main to the premise and all interior piumbing. (Per City code
402.06) 1 also hold the City of Fridley and/its emqloyees harmless fo�any damages that may occur
while doing this operation. This to include,but not limited to;valves,piPinB.walls,floors or the curb
stop box and service tine. i understand 1 am also required to obtain a permit prior to any work,if
necessary.
r readin old meter �� � � �� " V
Final mete g( � �C�� _„�.�cp
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Name• A�rressc� � `
PhoneNumber• Date: ���I�
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Slgnature�_,_
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,ANO SANITARY SEWER
ADMINISTRATI�N
(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 cunnecting the existing municipal system and any house
o�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 tMis Code. After such connection has been
made,the Water and Sewer Department shalf be notified. It shall be unlawful to cover any connecting line until an
inspection has heen 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 propecty 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 iines
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 shali be charged for the costs of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative
poticy. It shall be the responsibility of the applicant,awner,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
waCer service curb stop box for operability and at such height as wi11 ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
Request Number; 6278
� Pubfic Works Division
Service Request
Problem Address: 6472 Rivierview Terrace Requested By: Kory Jorgensen
Department: WATER Address: No address provided :
Problem/Issue: WATER SERVICE LEAK(WATER) Phone Number:
Scheduled Date: Scheduled Time:
ACTION NEEDED: Water service leak on Saturday. Kory hooked homeowner up to neighbor.
Created by: Wendy Hiatt Date Created: 2013-06-24
ACTION TAKEN:
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Status: tn Progress Resident Contacted �
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Date Completed: /° ^2 Jf'�� '3 Completed by:
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