Meter Swap '= ��-�I.S c�Ys;�Y��/�ri�
I S�ALLATION
unroF AUTOMATIC METER�READER
FRIDLEY
Address �� (f \t�� • �<
Name - �`1�A �t�A�7�
Date ��y—��
Old Meter Number '1
Old Meter Reading ;�l.J C�� �
Replacement No., �� l� 'i�
Replacement Reading �
Replacement Make
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ERT# ��� ��jl�
Replacement ERT#
Remarks:
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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 to replace the water meter, I understand that the property owner
is liabie for the water line from the main ta the premise and all interior plumbing. (Per City code
402.06) i atso hold the City af Fridley and/its employees harmless for any damages that may occur
while daing this aperation. This to include,but not limited to;valves�piping,walis,floors or the curb
� stop box and service line, i understand 1 am also required to obtain a permit prio�to any work,if
necessary. � �,.
Final meter reading(oid meter) `'�``l � � /� �
Name� Address: CJ� ,�� `��
Phone Number. Date: �� `_�
Signature: "
Witness Signature:
FRIDLEY CITY CODE
CHAPTER 402.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402A5. PERMIT 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 permit for such
connection,and shall pay a permit fee as provided 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 connecting line until an
inspection has been made and such connection and the work incident thereto has been approved by the City as a
praper and suitable connection.
402.06. REPAtRS AND MAiNTENANCE TO CONNECTION
After the initial connection has been made to the water service curb stop box or the sewer lead at the praperty
line or a water service or sewer lead has been extended to the property line for connection,the appiicant,owner,
or the occupant or user of such premises shall he liable 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 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 annuaily by an administrative
po(icy. It shall be the responsibility of the applicant,owner,occupant or user to perform standard maintenance of
the sewer service line from the premises to the main inciuding 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: 11097
Public Works Division
Service Request
Problem Address: 820 Mississippi St Requested By: Sara
Dep$rtment: WATER Address: No address provided
Problem/Issue: LEAKING ME1ER Phone Number: 1-715-497-0645
Scheduled Date: 2016-01-11 Scheduled'lime: 08:15:00
ACTION NEEDED:Water spraying out of ineter corniection.
Createdby: WendyHiatt DateCreated: 2016-01-11
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed by:
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