Meter Swap Request Number: 11004
Public Works Division
Service Request
Problem Address: 5429 E Brenner Pass Requested By: 5herree Smith
Department: WATER Address: No address provided
ProblemlIssue: INSTALL AMR METER Phone Number: 763-572-3612
Scheduled Date: 2015-12-14 Scheduled'ISme: 02:30:00
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ACTION NEEDED:AMR
Created by: Wendy Hiatt Date Created: 2015-12-08
ACTTON TAI�N:
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✓ ..................._._.........................................................
Status: In Progress Resident Contacted ❑
Date Completed: Completed by: �
Hours
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ia.�y-�s
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- ccy of F�a��y
- . _. _ Wat?r Qepartment ,.. _ : _. ... .
6431 Unive�sity Avenue N�
F�ldtey,MN 55432
(763�572-3566
t/we
hereby authorize d►e��1i�kidiey and/ar its
empioyees to do what�S r�cessary to replace the wat+er meter�t understand t�hat the propertlt owne�' .
e r line from the main to the prem�e and ad�terior plumbi�. �P�"��
4�t,0&) i.alsa hotd the City af Fridtey and/'�s employees harnde� °r a�y �m�� +
white doing this operadon. This tu indude,6ut not Gmited te;+ta��►P��•'�I�,flaors or the curb
stap hmt and senrics line. 1 u�d�rstand i am afso required to abt�+�Pe+m�P�or to any woric,if
necessa�ry.
Final meter reading(otd meter} . . � �
Name: Address: � �
Phoee Nurn6er: � �
. '\�
�
5'ignature.
iNitnpss Signature:
� FRIDLkY qTl(CODE �
CHAPTER�ID2.WA7ER,51'�tM WATEtt,At��tITARY*EWER
AaMINi57RATtC1N
(Ref Ord Mo 113t 454f 565r 556,6Z9,638,662,9Z2,988,1144,1156,1191}
4A2.OS.PERMR�EE .
Prior to canstructing or�epair of any water ur sewer line con n����ben�equ`�ed to o6tain a permit for such
ar 6uifding for which the appiicab°��s made,the pwner or co
wnrrection,and shal{pay a permit fee as pravided in Chapter ii of�isCode. After such cans�ctian ha5 b�
made,the Water and Sewer Deparhnent shall be no he work ndd�tt thereto,thas heen RP���Y��Y as an
inspection has 6een made and such cannecCi�n and
prnperand suitable connecttnn.
402.06.REPAIRS AND MAINTENANCE TO tONNEC(t�N
ser�ric�cur6st bax or the sewer iead at the prapert'
-p�a-iadia
tine or a water service or sewer{ead I�aS b half be ltabie fnr a1��epa�requir d i�an1►w er{irie aand sewwer I���
or the a�tiipant ar user af such premises 9���u�
necessary for connectian�a�►s 6ee erformed hy the Ctty�tha P op�ty owiner sl�ati b��ged far the ca�ts of the
maintenance 5ervice ar rep R
. maintenance andlor repai�s, including ae an��t+Qwnert occup�t�r uset otpet�o�Standard maint�anc�4f
poticy. 1t shall bethe responsihi{ity ofth PP
• the sewer service line from�e premi�es��the m�in inc{udi�g���u en�a{�tma�5 above th fiini hjed �
. water 5ervic�cur6 stop boxfnr operabilfi+and at suth heigh . . . . . _ .- :,... • . ... . . ..: : = .
`8e€635,#.�55,:l.�-��:) .. __ _ . . .� -
_ _..- --. .. ...__ . _. . .
„'grad"e of��r��larni or�rap�rty�t