Meter Swap Request Number: ll599
Public Works Division
Service Request
Problem Address: 4526 2nd St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
Scheduled Date: 2016-06-24 Scheduled 17me:
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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Status: In Progress 5ubmitter Has Been C,
Contacted
Date Completed: �1—Z�^ l� Completed by: CptQ NQ.��
. ' � Cit�o#�ridfe�
- . _ . Vslat�r Depa�trnen� _ __ . �...
6A31 Univeesidy Avenue N�
fridley,Rt{N 55432
{763�572-3566
lJwre hereby auth�rize th��$ty of Fridley andjt�r i�s
empioyees#o do whafi i�necessan�ta reptace the water meter, (understand that the prap�rty owner
�liable for the water I�ne from the main to fihe pr�mise and ab��r��T P���b��• �Fer C�ty eade
402.�j I.a{sa fiuld the C'riy of fridfey and/its empinyees harmless#+�r any amages t maY oc �
whii�doing this aperatiun. This ta iadude,b�n+�t i�mited#o;uai+�P��in�,�alls;�laors or the carb
sCop bnx and servire line. 1 understand I am also requ�red to ahtain a permit prior ta any work,if
necessary.
F'mal m�ter�eading�old meter3 h� 1 �
Name•
����: ��a6 a�� �+ .
Phone 1Vumher• itata: � ����
Signature• -
Witness 5egnature•
H{tDL�t CiTY C�)DE
�H1iPYER 4t12<W1�i'El�,St'�RM WATER,APf��ANNi7'Ai�Y 5E1NER
ADM1NtS9RAT4Ufi1
: (Reff Clcd No 113,454,5�5;566,629,638,56Z,922,988=1144,1156,1191j
4ti2,05.PERMfT'FEE �
Pnar to cans�ructing or repaic af any weter or sewar line c�anectingt�e existing rnllnicipal system and any house
or buiiding fior which the appiication is made,the awner or cont�'acfor shall be requi�ed ta obtain a pesmi��or sueh
canrtectiant and shali pay a pesmi�fee as prauided in C�►aptec 7.1 of this Cnde. After such cannectian bas 6een
made,the Water and Sewer Department shall be natifted. it shaii 6e unfawFui to cavec any conneeting iine until an
inspection has been made and such canne�ti�n and the�vosk inc�dent theret�has 6een appcaved by�lte C[ry as a
prnperand sn�tab(e connectian.
40�.OS.REP�1R5 A111D Mi4tNTENANCE TI��C�7N1'r1Ei;fttJ.t�
-A#�r�-;ai�ia�rnn�p�tn�has hp�r�rnacL��2��water service curhstoo bax ar the sewer iead at the propert"
line nr a water service or sewer fead has been extsndQd#4 the propertyline for cannectian,#he apptica�,owner,
or the occvpant qr user af such premises shail be liahie for al[�epal�s required�r etry water[ine and sewer tines
ne�es�ary for connectian af the premises from the main ta the pr�ises, if the prop�ly owner requests
rnainfienance serUic�e�t repairs he performed bp the City,the prnp�atp flwrrer sha{1 he charged far tk►e ca�ts of t�ie
maintenance andJar repairs, including any neces�ary street repairs,ak a rate set annnalty by,an administrative
pv(icy. (t shall be the responsihility of the applicantr awner,occupant ar user to perf�rm standard maintenance af
� the sewer service ffie from the premises ta the main inc(ud'+ng de6r�dear'sng flr raot cutting an�to mainta'sri the
water s�rvice curh�top box for operability a�td at such height as will ensure that it remains a6ave the finished
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