Meter Swap Y.
. - Request Number: 11621
Public Works Division
Service Request
Problem Address: 4561 2 112 St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
5cheduled Date: 2016-06-24 5cheduled'Iime:
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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, Status: �n Progress Submitter Has Been C.,
Coutacted
Date Completed: Completed by:
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, ., ' - City of�ridle�
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64�1 tlniversity Avenue NE
F�idley,MN 554�2
{7�3)572-356fi
ljuue hereby authQr�ae the�fi(�f fridiey andjtrr its
employees ta dv wh�t�s necess�rq ta replace the wat�r meter. t urtderstand that the property owner
is liable far�tre water line from tfie mat�v ta the premise and a�ir�r�ar ptambing. (Per Ctty cade
402,06� i.alsa hold the�"rty af�rtdley andJits�empbyees harmisss or any amages maY�
while doing this operatian. This to indude,hut nat tirnited ta;uaW�P�P�n�•wa(ts,fl�ors or the cur6
stop bax and service line. t anderstand(arn alsa required t+n ahtain a permit prior t+a any wark,if
necessary.
. �nal meter reading(oBd meter�
Name• Address•
�! Sf f �ya ��"
Ph�rae Kuml�er; #e' �
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Signa#ure:
Witness 5ignatnre�:
. ftt1DL1EY Ct1Y C�lDE
C6iAPYEFi 4flZ.WATEit,ST�RM 1i41�TER,ANO�ANI�'ARjI SEWER
AaMINlSTRA�'iQN
(Ref+�rd�l0113,454,555;556,6�9,638,562,922,9&8,1�.44,1556,1191)
4f�Z.p5.P�RtV�iT FEE �
Prior to canstrueting or repair oi any water or sewer tin�cc�r►nectingtfie existing snunicipai sys#em and any hause
or Building fr�r wh'sctti the appiication is mada,the Qwne�o�-ca�racG�t shall be requtred to obtain a permi�fo�such
cc�nrsectianr and shait pay a perms�fee a5 pravided{n Cha�tec 7.1 of�is Cade. Afiter�uch connec�ion has 6een
made,the'uVater and Sewer Department shall be natifted. It shali be unlawfui to caver any cat�nect�ng tme until an
[nspectian has heen made and such cannectian and the work incident thereto has 6een apprflved by the City a�a
properand su'�able connecti�n.
402,06.i�EpA1Rs AAtD I�IiA1N3ENAiwICE T4��O�INE�;T113N
-A#t-�r-���-iRi�ia:r^^ryn�t^"has 5v�n rn�d_e tn th�water serv9ce cu�6ston bo�c ar the sewer tead at i�e prope�t"
line or a water service ar sewer fead has�een extended to the property line#or cannecdan,the apptica�,Awner,
or the occupant or user af such prem�ses shaf!be 1iable faf sll�epaf�required to any watQr 1'sne and sewer line$
necessary for connectian afthe premise�from the main#o the pr�nises, ifithe propecty ov�mer r+�uests
maintenance senirce�r re�airs he perfnrmed 6y tfie City,tfie prop�ty awner shall be charg�d�Or the co�ts of the
. maintenance and/or r�pairs. inc{uding anY necessary s#s'eet repai�s,at a cate s�t aanual(y byar+adm9nis�rathre
po(icy. 1t shali hethe responsihiliry afthe applieantr awneG°��uPantor userta perForm�tandard maintenartte of
� the sewer service line from the prernises ta the main inc[uding dehrls clearing or raot cu�ing and ta maintaia the
watgr service cur6 stop box fflr operabilitY and at�uch height as w�i en�ure that it remains abave the flnished ... . ..
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