Meter Swap � � `}��INSTALL�.AT ON�3��
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c�.��. AUTOMATIC METER READER
FRIDLEY
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Date � � LU `l �
Old Meter Number � �1��
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Replacement No. L �G � S`
Replacement Reading_�'�
Replacement Make �l�S�'�
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Replacement ERT#
Remarks
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City of Fridley
Water Department
6431 Universiiy Avenue NE
Fridiey,MN 5543Z
(763)572-3566
1/we hereby authorize the City of Fridley and/ar its
emptoyees to do what is necessary to replace the water meter. 1 understand that the property owner
is liable for the water line fram the main to the premise and all interior plumbing. (Per City code
402.06) I alsa 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 tu;valves,piping,walls,floars or the curb
� stap box and senrice line. I understand I am also required ta obtain a permit prior to any work,if
necessary.
Fina!meter reading(old meter)
Name: Address:
Phone Number: . Date: •
� Signature:
. Witness Signature: '
FRIDLEY CITY CODE
' CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINIS7RATIQN
(Ref Ord No 113,464,565,566,629,638,662,92?,9S$,1144,5156,1191)
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 be required to obtain a permitfor such
senflee�Ten,and shall�aTa-^prmit faa at rovid d in Chapter 11 of this Code. After such connection has been
made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any conne ing`�n L���
inspection has aeen made and such connection and the work incident thereto has been approved by the City as a
proper and suitable connection.
4Q2.06.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 properry line for connection,the applicant,owner,
or the occupant or user of such premises shall be liable for all repairs required to any water iine and sewer lines
necessary for cQnnection of the premises from the main to fihe premises. lf the�property owner requests
maintenance service or repairs 6e perform�d by the City,the property owner shall 6e charged for the costs of the
maintenance and/ar repairs, including any�ecessary street repairs,at a rate set annualty by an administrative
policy. It shall be the respansibility of the applicant,owner,occupant or user to perform sCandard maintenance of
the sewer service fine from the premises to the main including debris clearing or root cutting and ta 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 for Ser�ice Report
City of Fridley
R eference N o: 601-11-2953 Date: 04/04/11
Requesk Type: Turn waker oFFfon Entered By: Wendy Hiatt
Department: Water Citizen Name: Mary•Tim's Quality Plumbing
Address: 6342 DELLWOOD DR NE Callback Phone: 763-571-0454
Scheduled Date= 04f04111 11=00 AM Property Owner: Lea Mills
Location Details: Leave Key Requesk Dekails_ Shut water off_ Leave key
""B I LL"xx
Action Taken:
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Responsible Person: �.
Approver:
Completion Date: w� `�� / �� � Citizen Noti(ied
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