Meter Swap � Request Number: 11622
Public Works Division
Service Request
Problem Address: 4551 2 1/2 St Requested By:
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Number:
Scheduled Date: 2016-06-24 Schedul ed'IS me:
ACITON NEEDED:
Created by: Wendy Hiatt Date Created: 2016-Ob-23
ACTION TAI�N:
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Status: In Progress Submitter Has Been �
Contacted
Date Compieted: Completed by:
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. � �ity�f Fridley
• - _ .. iAla#�t�epa�ttnent ._ _ .. _, �...
64�1 Un'srr�rsi#y Avenue NE
Fridley,MI� �5432
(763j 572-3566
g(ure hereby authorixe the�tY af Frid[ey and/or its
empl4yees#o do what�necessaay tm replace the water meter�I enderstand that the property awner
_is lia6te for the water Iine from the maic�to the peemise as►d all interiar pl�umbing. (Per C�ty cade
q02.�) t.als,�fic�1d the C�Ey of Fridley andJits employees harmlrss��r any amages may "
wh�e doing#his aper�don. This#v indstdet but nat timited to;valves,Piping,wails,floors rn'tF►e cur6
�tap 6ax and�+ervice line. t understand t am also required to ahtain a perrnit priar to any work�if
necessary,
. Einal meter r�ading�otd meter� q .
Name• Address:��_ ��� 5 �
Rh�ne fUumber•
Signa#ur
Wi#ness 5ignature;
�RIDLEY C1TY G�DE
�HAPTEt�4[1Z.WATEa�5'9'�RM WA'fEli,R1a05ANtTARY SEWER
,�DMINlSTRATIt1N
(Ref t3rd Na i13,464,555;566,EZ9,538,£6�,42�,988,1�.44,1156,1191)
40Z.05.PER�►li�`F�E �
Priur to canstructing or repa9r af any water or sewer fine connectingthe existing municipa{system and any hause
ar huilding for which the apAlicatian�$►nade�the°wner ar contrac�r shal)be required to obtain a petmi�for such
cc�nr�ectian,and shali pay a pefmit fiee as pravided in Cf�apter 11 of this Code. A#ter such cnnnecfian bas been
made,the luater and Sev�rer Department shai}be notified. 1t shafl 6e unlaw�ul ta caver any cor�necting fine until an
inspec�ion has been cnade and such�onnection and the work incide�rt thereto has 6een appraved by the City as a
prnper and su��6le connectf4n.
4�2.00.REA�tRS A�iD N1AiNTENANCE TO��NfiIECi'1QN
.__�.__��na,,,�aa+��he water service curhs�o b�c nrthe sewer lead atthe pmpert�
-A�(�e-i�itiaL.cnnue�;:.��.�.LA.=.•,-�------
line or a water service or sewer lead has heen extended t�the praperty line tor cannection,#he applicant,uwner,
ar the occitQant or user af such premises sha41 be liabie tnr a!(�epai�reqnrred tn any waker i�ne and sewe�fines
ne�essary for connectian af the prernises from the main#a the pr�tises, if the propetty owner requests
maintenance service ar repairs 6e perfarmed by the City,the propetty owner shall be charged far the co�ts af tt+e
. maintenance and/ar repairs, inciuding any necessary street repairs,at a rate set annually by.an admini5traative
palicy. It shali be the responsi6itity ofthe�pplicant,owner,occupantor user ta pe�orm�tandard rnaintenance of
• the sewer service line fram the prernises ta the main including dehris clearing or raot cutting and to maintain the
water sennce cur6 stap hox far ope�ability and at such height as w�l ensure fihat it remains abave the finished .
<"grac�"e of����tand ar-�r��`%Y•-(Ret 6�0,y�55,-:t���:� _. ._ . _ � --