Meter Swap Request Number: 11609
Public Works Division
Service Request
Problem Address: 4519 2nd St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
Schedul ed Date: 2016-06-24 Sc hedul ed'I5 me:
ACITON NEEDED:
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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Status: In Progress 5ubmitter Has Been �,
Contacted
Date Completed: Completed by:
��� �,r`/�
` � - City�f Fridiey
- t�lat�r��pa�hnnent . -. �- -
6A�1 llniv�rsity Avenu�NE
Fridtey,Mt� 55432
�753)572-3566
t f.we here6y authQrize the�tY of Fridiey andjor its
empfoye�s to do wh�fi'is necessa,y to reptaee the water met�r, t����d�����0e�r°p��°��r
is liab� fnr the water line frorr�#he main ta the premisa a�d ail int�r�or plumbing. �Fer tity code
A[i2,D6) f.atsu hnld the C�ty of Fr3dley andjits emplayees harmiirss �i��y �n►�g� a may oc �-
r�hiUe dc►ing this aperation. This eo indude,bu�not t�mited ta;uai�es�PiPing,wal(s,flaors or the curb
stop box and service line. !understand 1 am aiso required to abtain a Perrnit Prior t�a any work,if
necessary.
. �inat me#er reading(old meter} � ,
S�"
Name: Address: �J'�` � ��'� ;
PfioneiVumbe�: Dats' �D� �! �
Signa�c re•.
Witnn�ss 5ignature� _
' �.
�RIDLEY�ITI C�IDE
CNAP�'ER 40Z<W�7'�Rr S3'+�RM NtATER,ANU�ANiTARY SEWER
�gM1N153RATIt1Pt
(Ref{tr��to 113,4fi4,565;566,6�9,638,552,922,988,1�.4�4,1156,�191�
4i��.�5.f"�RMf3'FEE �
Frior to canstructing�r repa9r of any water or sewer fin�connsctingthe exlsting snunicipal system and any hause
or building ft�r which the apptica�ion is made,the awner or cor�fi�actar shall be requ►red to abtain a petmi�fror such
COilltl'CUQIir and shali pa}+a permi�fee as p�avided in CE�apter 11 ofthis�de. A#tec such cannectian has 6een
made,the iNater and Sewer Department sha11 b�nafafzed. 1t shall 6e untawfui ta cover any conneeCing Grie urrtil an
inspection has been inade and such connection and the work incide�thereta has 6een apprnved by the�ifiy as a
praperand�u�ta6le connection.
4Q2.06.�EPAIRS�[�43 MA1N7El�1ANCE TO Ct�NNE�TII��I
-A�t.�-iui#:�u:�u�erssnn.b�s �n n�ac���th�water service curhsta�bcut ar the sewer lead at the propert�
line nr a water service ar sewer tead has been ex�ended to the property line#or cnnnection,the appl�c�t,owner,
or the occup�nt or user afi such premis�s shail be lia6te fvr alI�epa�s required i�any waker(ine and sewe�lines
necessary for�cannectian oF the premises from the main to tF►e prem9ses, tf the propetiy owner reqvests
rna�nfienance service�r repairs h�perfo+-�+ed bY�he C�ty,the Propett}+awcter ShaA be charged far the costs of the
. meintenance and/or repairs, including any necessary street repairs,at a rate set annaalty by.an administrat3ve
policy. 1t shafi be th�responsitiility of the appli�nt�owner,occupantor user ta perForm standard maintertance af
• the sew�r 5ervice Gne fr4m#�e RC�m�$�5�°the main inciuding dehris clearing or raat cutting and to mairitairi thQ
water service curh stop bax for aperability and at such height as wi�en�ure tl�at it remains abava the finished .
-:'graii"eoftf►�ta�dor�ru��i.y.��R�6 0,�.�5,t��1� _. ._ . . - . -.