Meter Swap Request Number: 11618
Public Works Division
Service Request
Problem Address: 4514 2 1/2 St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
SchedWed Date: 2016-06-24 Scheduled Time:
ACTION NEEDED:
Created by: Wendy Hiatt Date Created: 2016-06-23
ACTION TAI�N:
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Status: In Progress Submitter Has Been C,
Contacted
DateCompleted: u _ 16 Completedby: Co�e Ne.lsd�
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- City o#Fridley
- . _ 4Ala#�r�+�partanent . _� ,� .
���1 tln6versity A�enue NE -
Frsdley,M{� 55432
(753�5�2-3566
(/we hereby authc�riae the�ht a#Fr�dley and/or ii�
amployees#o do uvhat is neeessar�to reptace the wa#er sneter, t understand that the property awner
—is liahle for the water{ine frorrz the main to#hs premise and ail ir�terior plamlaing. (Per CCiffy code
402.�Q6) l.ais+�hofd fihe+C�.y nf�r3diey and jif�employees harmiessfor aa�y amages maY�+' cur
while doing this operativn. This to inc{udet but nat timited ta;uaiv�s►P�P�ng•��r�Q°�or fihe carb
stop 6atc and s�rrvice(�ne. i understac�d i am also required to ahtain a Permit prior to anp work,if
necessary, �
. �r+a1 m�ter�eading(olci meter) �4 f���o
Name: Address: 1"'� s� i"'' d��'�, �'J T
Rhane Numb aate: (^�('� '_ l D
e
Signature:
Wt�tness Signature�
�RIDLEY C!'fY CCiDE
CHaPi'ER 4t]Z=WAg�,STORM WATER,AND 3AN1TAttY SEWER
A►aMINISTRATION
(Ref Ord No 113,�54,565;556,629,638,562,9Z2,988,1144,�.155,1191)
4UZ.05.PERMIT FEE �
Pci�r to canstructtng oi-cepaic Qi any water ar se�rar lina cQnnectingifie existing municipa!system and any house
or building for which the application is made,the awner ar confrac�r shall be reguired ta ob�ain a permi�for such
conrrectionr and shalt pay a permi�fee as Pcavided in Cfiapter 7.1 of�his Cade. After such cannectian 6as been
made,the�Atater and Sewer Department shail be notified. It shal!6e unlawful to caver any conne�ting fine un#il an
inspection has been made and such cannectiDn and the wo�1c incide�theceto has heen appraved 6y the CitY as a
praperand s�itable cor�neCtian.
4i12.d6.REPAIRS A�tD MAiNTE�IAfVCE TQ�ON�IE+CT113N
-A#�r��aiActia' --�--`�--`'-�`�'""aa+"�he ur�ter serv"tce curh skoo bnx flr the se�rer lead at the propert�
line or a water service or sewer lead has been extended to the proper�riine#or cnnnecttan,the appli�r�,nurner,
or the�ccupant qr user af such premises shail be lia�bte foc ali repalrs required t�o any water fine and sewe�'lines
necessary for connection�of the premfses from the m�in to the�pr�ises, if the propetty nwner requesfs
maintenance service ar repairs he perfarme�by the City,the praperty owner shail be charged for the ca�ts of the
. maintenance and/ar repairs, inciud'+ng any nece�sary street repairs,at a rate set annually by.an administrathre
poli�cy. It shall be the responsi6ility af the aFP�►cant,6wner,occupantor user ta perfomt standard rnain#enance of
� the sewer service line fram the premises ta the main including dehr�c{earing flr raot cutting and to mairitain the
water service cur6 s�op hox for operabilitY and at 5uth height as vu�ensure fihat it remains above the f+nished .
. .
-::gracte of��i�tarci crr-pra�ti.y.-�R�630,�.�5,_t�g�� _- .. . . . .
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