Meter Swap Request Number: 10816
Public Works Division
Service Request
Problem Address: 5553 E Oberlin Circle Requested By: Shirley Flom
Department: WATER Address: 5553 E Oberlin Circle
Problem/Issue: INSTALL AMR METER Phone Number: 763-574-1699
SchedWed Date: 2015-11-18 Scheduled'I�me: 01:00:00
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ACTTON NEEDED:AMR Install
Created by: Cheryl Pellegrin Date Created: 2015-I 1-12
ACTION TAKEN:
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Status: 1n Progress Resident Contacted [�
Date Completed: Completed by:
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Gty of Fridley
� Wat?r[�epartment
6431 University Avenue dE �
Fridley,MN 5543Z
(763�5723566
Ijwe hereby authorize i��tl►af fridtey and/or its
employees to do wh�t i�necessary to replace the water meter.����that�p�e�°W�
water Iirre from the main to t�e premise and a����Z°�'P��mbing. �P�r UtY ca�
A02.06� I.aisa hold the C�ij►of Frldley and/'�s employees ham� r��y amages
while doing this aperadon. This to includet but not limited to;v���P�P�ng►��►flOQrs or the curb
�op box and seniice line. i understand I am atso repuired to d��Pe�rt P�drt°any work�ff
necessary.
Flnat meter reading(old meter) . ,
Name: Address• � :
Phone Num6er� � ��' �
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Signature: �
Witn�5ignature: � �
� FRIDtEY CITY CODE
CHAPTER'1�2.WAf�fl,51'ORM WA1�R,ANU�INCfARY SEWER
ADMtN{51RATtQN
(Ref Ord No 113,4fi4,565;556,6Z9.638,66Z,912,988,1144,1156,1191�
4�2.05.PERMIT FEE -
Prior ta constructing nr repair af any water or sewer line connectingthe erdsting municipai�ystem and am hause
or building far whic�the application is made,the owner o te�i o�S�Codee�er su�ch cann ieetia��beet+ c�
cannectian,and shal!Qay a pe�mit fee as provided in Chap
made,the Wate�and Sewer Deparime�necti'an and he work ndd theretal h heen approved�the[7ty asI an
inspection has heen made and such ca
properand suitabte connection.
402.06.REPAIRS AND MAlNTENANCE TO CONNECTIO'�
��p� r service a��st box arthe sewer lead atthe praperC'
line or a water senrice or sewer iead has been extended to the propertyline far connection,the appticant,oW���
ar the oceuQant or user af such premtse�sha41 be liabie for el[repa�cequired ta am/wato�n�e a�n�d�G��
necessary for connedian of the premfses from the main ta the pr�ai�es. tf the prop�[[ty
maintenance service ar repairs be performed bY the City,the prap�ty owner shafl be rharged for the co�ts of the
maintenance and/or repairs, includinB anV neces�ary street rePai�at a rate set annuaNy by.an adminfstrative
po({cy. It shait be ifie respo�ihi�itY oft�e�pp���n�`°�er,occup�nt�r user ta perform standard mainkenancQ af
• the sewer service line from the p�emises ta the main inc{uding del�clearing flr raot cutting and to main�ain the
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water service curh stop bQxfnr operability and at 5uch height as u�y ensure that it rematns abave the n�s
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