Meter Swap �S`�t 5� —��G�c'c�v,
�� ��-� INSTALLATION
U.NOF AUTOMATIC METER READER
FRIDLEY
Address ���1C% " �C.���� �-�
Name �v�t� C'�Z�Z.=��
Date �-�—`�
Old Meter Number u�� 3 i
Old Meter Reading 1 ���
Replacement No. � 1 �ac�c� 1�
Replacement Reading �
Replacement Make � �
_ ,�..,a ''�
ERT# Cj� � �f � y
�4/
Replacement ERT#
Remarks:
--��� Signed:
F���t f�r�er�c� R
C�iy c�f �ndl�
� �. �I-1z-�1 a . 4 12
T�e: AI�iFi�ex �r# �r: W 3t�t
�rt�: Wat� C�r�� �Pe�r�
Add�_ ,��A11E 1MIE �Ca�ic�rr�: 763�7�-�6�i
S�d�i�d[�e= �7�9rtIF!/k�l� �y t3w�:
t�€�ai�s: �[Ie�s: Ai�i
Ia[�:
�Id �+�t�r � a �� � 3 �
��� �����: a�a3 ot-c�
�J+��v ���r # ���� ��C��
1��r�ur ��adir�g: �
��T� 333�o� ��
, �;
�,��"� � _____._______ . .. �.____.��_.__.._____..________�..__�__..............
� �
,
�__._._ _�_.��_�_... ___ .�.. _.��____�._.
��- L �
.1-a�_-_i�
City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
I/we hereby authorize the City of Fridley and/or its
employees to do what is necessary ta repiace the water meter. i understand that the property owner
is liable fvr the water line from the main to the p�emise and ail interior piumbing. (Per City code
402.06) i also hold the Ciiy of Fridiey and/its employees harmless for any damages tha�t may occur
while doing this operation. This to include,but not limited to;valves,piping,watis,floors or the curb
� stop box and service line. 1 understand 1 am also required to abtain a permit prior to any work,if
necessary.
Final meter reading(old meter� v �
Name• Address:_ / / � " ��� ��
Phone Number: e: �� — ��
Signature:
Witness Signature: �r�G�'�"''^'�--
FRIDLEY CITY CODE
CHAP7ER 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 const�ucting or repair of any water or sewer line connecting the existing municipal system and any house
or building for which the application is made,the owner or contractor shalt be required to obtain a permit for such
connection,and shail pay a permit fee as provided in Chapter 11 of this Code. After such connectionhas been
made,the Water and Sewer Department shail be notified. it shall be unlawful to cover any connecting line until an
inspection has been made and such connection and the work incident thereta 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 far connection,the applicant,owne�,
or the occupant or user of such premises shall be liabie 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 ownes requests
maintenance service or repairs be performed by the City,the property owner shall be charged for the cnsts of the
maintenance and/or repairs, including any necessary street repairs,at a rate set annuafiy by ar►administrative
policy. It shall be the responsibility of the applicant,owner,occupant or user to pe�Form standard maintenance of
the 5ewer service line from the premises to the main inciuding debris ctearing or root cutting and to maintain the
water service curb stop box for operability and at such height as wili ensure that it remains above the finished
grade of the land or property. (Ref 638,1156,1191)
��
�
- Request Number: 11127
,
Public Works Division
Service Request
Problem Address: 776 63rd Ave Reqnested By: Sue-Utility Billing
Departraent: WA'TER Address: No address provided
Problem/Issue: FINAL METER READING Phone Number:
Scheduled Date: Scheduled'Iime:
{,,,..� . .
ACTION NEEDED:Fina1 reading.Clo ing 1/27/16 RT#33370945
Created by: Wendy Hiatt Date Created: 2016-01-21
ACTION TAI�N:
...................................................._.........................................................................................._......................._.........._...................................._.........................................................._............._.._._............_..._............._.._........._._..__......_............_._.........
' ................................���..::...... ......`..-................�._�._�l/..�....._........_....................................................._........._....................................._........._......_..._.._....._._.__..._..........._..._.__................_
�
.......................................................................................................................................:......................................................................:..................................................................................................._................_..........._..__.._..............__........._................
........................................_...................................................................:..............................._.............................._.....................................................................:.........._......_..............._..._.._...................._........_.........._....................._.....................____.....
Status: 1n Progress Resident Contacted C''
Date Completed: Completed by:
_ �. f��(�
I a� �� - �
Hiatt, Wendy
From: ' Johnson, Susan E.
Sent: Thursday, January 21, 2016 9:19 AM
To: Hiatt, Wendy
Subject: Final Meter Reading
Hi Wendy,
Request for Final Meter Reading:
776 63 Ave NE
Closing date: 1/27/16
Ert#33370945
Thank you!
Sue�oRnav.c
City of Fridley
Utility Billing
763-572-3529
My office hours:
Tuesday,Thursday& Friday
8am-4:30pm
1