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Fridley •
S�P "� .�st Number: �8za8
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Public Works Division
Service Request
Problem Address: 5411 Sth St Requested By: Walter Lach-Sacred Heart
Cemetery
Department: WATER Address:
Problem/Issue: INSTALL AMR METER Phone Number: �
Scheduled Ds�te: Scheduled Time:
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ACTION NEEDED: AMR 2"
Created By: Wendy Hiatt
Date Crea�ed: 2018-05-15
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ACTION TAKEN:
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Status: - Submitter Contacted: false
Date Completed: Completed By: „
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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 FrFdley and/or its employees 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 402.06) 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 iine. tn understand 1 am also required
to obtain a permit prior to any work,if necessary.
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FINAL METER READING(old meter)
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Name: Address o � v)� ��7
Phone Number Date L�` ` �
Signature Witness Signature
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OLD METER# ��5 d r"� 7C7 SIZE & STYLE Circte
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OLD READING l`rG-l � � 5/8" EX
NEW METER# �t����b Z� 1" HEX
NEW READING �U 1�4" ELIPTICAL or HEX
.
ERT# � � ! �� I ( 2" ELIPTICAL or HEX
FRIDLEY CITY COOE
CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER
ADMtNISTRATION
(Ref Ord No 113,464,565,566,629,638,662,922,488,1144, 1156,1191)
402.5 PERMIT FEE
Prior to constructing or repair of any water of 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 conneding 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.
402.06 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 lead has
been extended to the property line for connection,the applicant,owner,or ocwpant or user of such premises shall be liable for all repairs
required to any water line and sewer lines necessary for connedion 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 necessary street repairs at a rate set annually by an administrative policy. 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 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�nished
grade of the land or property. (Ref 638,1156,1191j �