Meter Swap � `J��� � INSTALLATION��?�
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u.�� AUTOMATIC METER READER
FRlDLEY
Address �;����� ��.L ��
Name �t_.E.�;� ��2"�t�
Date t�—'��"`���
Old Meter Number � t���� �
Old Meter Readin t40� �
Replacement No. Z"l�� l��r�1
Replacement Reading �'Z5
Replacement Make
ERT# �3�0 c��t%C� '
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
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
402.06j 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 ta any work,if
necessary.
Final meter reading(old meter) ��
Name: • Address:,�Q ` "�
Phone Number: Date: `�✓v 4� �
./a �I � " A,�„
Signature:'�7'•.11//� ��m� `-
. Witness Signature:
FRIQLEY CITY CODE
CHAPTER 402.WATER,STORM WA7ER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565r 566,629,638,662,422,488,1144,1156,1191y
402.05. PERMlT 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 application is made,the owner or contractor shall 6e required to obtain a permit for such
connection,and sha{f pay a permit fee as provided in Chapte�11 of this Code. After such connection has been
made,the Water and Sewer Department shall be noti�ed. lt 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.
402.05. REPAIRS AND MAINTENANCE TO CONNECTIUN
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 app�icant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water line and sewer tines
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 street repairs,at a rate set annuatfy by an administrative
poticy. It shall be the responsibility of the appticant,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 638,1156,1191)
Request Number: 7498
Public Works Division
Service Request
Problem Address: . 64�5 Able Street Requested By: Renee Berman
Department: WATER Address: No address provided
Problem/Issue: FROZEN WATER SERVICE Phone Number: 763-571-9529
Scheduled Date: 201402-12 Scheduled Time:
ACTION NEEDED: Frozen Water Service. Gav�e her Ende Water phone number. Please call customer.
Created by: Jeannie Benson Date Created: 2014-02-12
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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