Meter Swap � �``���INSTALLA ON�a~�
�� AUTOMATIC METER READER
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Name •��s� �CSt��dCZ
Date �`���'`� tT�
Old Meter Number ��h �
OldMeterReading ���� .��a
Replacement No. �� «��
Replacement Reading �
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Repiacement Make �"��
ERT# ���� C'���S
ReplacementERT#
Remarks:
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��e�: Wat� fi.�F�z��e: Steve V�as�ta�
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• � � C11`y Of FI'Id�OY
Water Department
6431 University Avenue NE
fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley andJor its
employees to do what is necessary to replace the water meter. I understand that the property owner
is liable for the water line frflm the main ta the premise and all interior plumbing. (Per City code
402.06} t atso hotd the City of Fridley and/its employees harmless for any damages that may occur
while doing this operation. 7his to include,but nat fimited to;valves,piping,wa11s,floars or the curb
� stap 6ox and service 11ne. I understand 1 am also required to abtain a permit prior to any work,if
necessary. ���
Finaf ineter reading(old meter) �. �
Name: Address: ��, �J � �
Phone Number: Date: � ���� �
Signature: � ' �
. Witness 5ignature: .
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND 5ANITARY SEWER
� ADMIINISTRATION
(Ref Ord No 113,464,565,566,624,638,662,922,988,1144,1156, 1191)
402A5.pERMIT fEE
Prior to constru�ting or repair of any water or sewer line connecting the existing municipaf system and anq house
or buildi�g for which the application is made,the owner or contractor shalf be required to obtain a permit for such
connection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such cannection has been
made,the Water and Sewer Department shall be notified. it shall be unlawful to cover any connecting 1'tne until an
inspection has been made and such connection and the work incident thereto has been approved by the Cty as a
proper and suitable connection.
' 402.06. REPA{RS AND"MAINTENANCETO 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 fine for connection,the applicant;owner,
or the occupant or user of such premises shall be liable for all�epairs required to any wate�tine and sewer lines
necessary for connection of the premi5es from the main to the premises. If the property owner requests
maintenan�e 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 annually by an administrative
policy. tt shal{be the respor+sibility of the applicant,owner,occupant or user to perform standard maintenance of
• the sewer service fine from the premises ta the main including debris clearing a�root cutting and to maintain the
water setvice curb stop box for operabi{ity 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: ll134
Public Worlic Division
Service Request
Problem Address: 6206 Carol Dr Requested By: Anoka County Dispatch
Department: WATER Address: No address provided
Problem/Issue: WATER MAIN BREAK Phone Number:
Scheduled Date: Scheduled'Iime:
ACTION NEEDED:Water main break.Gopher ticket#160220005
Created by: Wendy Hiatt Date Created: 2016-01-22
ACTION TAI�N:
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Status: InProgress ResidentContacted f':
Date Completed: Completed by:
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