Meter Swap s
Request Number: 12011
Public Works Division
Service Request
Problem Address: 7507 Tempo Terr Requested By: Sharon Plocienik
Depnrtment: WATER Address: No address�ovided
Problem/Isaue: LEAKING METER Phone Number: 763-�84-OQ85
Scheduled Date: 2016-09-21 Schednled 13me: 10:00:00
S1
ACTION NEEDED:Leaky water meter.Install AMIt.
Created by: Wendy Hiatt Date Created: 2016-09-20
ACTTON TAI�N:
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Status: In Progress Submitter Has Been r
Contscted
Date Completed: Complete
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� - �i�Q��ridiey
- . . _.._ U�la��a�D�partment
fi4�1 Uni�rsity Avenue�E - .. . -
�rid(ey,l�tl� 55432
{753)572-3565
!/we hereby authorize#he�tY vf fridley and/�r ifs
employees to do whafi is necessary ta r�place the water met�r.t�n�er�tand th�t the property aw�er
'�le fc�r the water line firom the main tQ#he pr�rnise and a1i�i�Q�P{'�mbing. (Per City cade
�02,�6� t.ais+�hQ1d the C�.y o#6r�dley andJit�employees harmlessfor any amages a me cirr"
while d�ing tfiis operafiran. This t�n inc{ude,b�t not Gmfited tu;ual�res,P�pi�g,+�[s,ftoors flr the cur6
s'top bax an+�s�nrice iina� 1 und�rs#artd 1 am also required tQ ohtain a perrnit priar to any wvric,if
- ne�e�sary. . ��� � �
. �inat meter reading�old meter} � _
Name: Address:^,_.___ c�_� l �����"
Phone Number; Date:!�,._'_�---
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Signa�use•
Wttr�ess 5ignatttre•
Fit1DLEY+�fTl C�DE
CHAPYER 4i7Z�Wl��'�F(,SfDRM WA`Cf.R,AfdD SANCt';ARY SEW�R
ADMINISTRA1'4t3N
(Refi OCd�IQ 113,464,555;566,6�9,638t 56�,922,988,1144,�156,1191}
492.05.PERMiT FEE •
Pr'mr tfl tan�tructing or repair af any water ar sewer linE conn�c6ng�he exi�ing municipal sys�em and any i�ause
ar huilding f�r which the appCca�an is made,the owner or corfi�ac�or�hal)be required t�obtain a permfi�for such
a
canrrectiarr,and sha!!pay a permit fee as prouidec!in Chapter 11 ofthis Cade. A�ter such cannectian has 6een
made,#fie lhlater and Sewer Department sha1S be n�t�#ied. tt shal!6e anlawful ta caver any cAnnecting lin�until an
inspec�ion has been made and such connec�ion and the work'sncide�thereto has heen approved by the City��a
praperand su'rta6(e cannectian.
�0�.06,REpi41R�Al1tD MAif�TENANCE TCi Ca1V�lEC97QN
-A#�r�k►�-ipi�i.con�ecSianhas hapn rnad�to th�wa�er service cur6 ston bax s�r�e sewer(ead at the prapert'
line or a water serusce nr sewer lead has heen extendecl to the propertyfine#or conne�tion,the appta�nt,owner,
4r the occupant ar user afi such premises shat!be liabie far alI repal�teqvired ta any wa#er line and sewer line$
ne�essary for connec�ion of the premises from#he main#a the premises. If the propeCk�r owner tequests
maintenancs sen+�ce flr cepairs hs perfarmed 6y the Crty,the properiy awner sha11 be chatged far the ca�ts of tk+e
. maintenance and/or repairs, induding anY nece�ary str'eet repai�s,at a cate set annualiyby.�n admini�rJkive
policy. 1t shafl be the responsi6ility ofthe applicatttf owner,oecupant�r user to perfarm st�ndard rnaintenance of
• the sewer service lins fram the premisas ta�t►e m�in including da6r�dearing ur raot cu�ing and to main�airt the
water servic�curh skop box fQr aperability and aC 5uch height as w�i ensure that it remains abave the f+nished _ .
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':: .de of t�i�ta�d ar rc� ��i (Ref 63�,�.�5,-��9�:} _. _ . .
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