Meter Swap Request f+�r S�rvio�: Rep�o�'#
. ' G�#y af Fndlewy
Referenee�: 6a2-12-42'� L1��: 2l81ZQ12
R�eque�t T�e� 11A�r s�ervit�e tine fr�+�d By: Wendy�#
D� . Sew�er �iz�hfi�ne: �,loat
Ad�� �1Q G7TH AYE NE adc Phc�ne: 7fi3 57�-0t3�4�
Sc�r��d Date: 2f5s/2�12 1�AM �rz�erty(3v�:
Loc�n I��Is: � Deta�s: 7V�Servicx-2012�t Pru�ect
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Request Number: 7991
Public Works Division
Service Request
Problem Address: 610 67th Ave Requested By: Michael Jast
Department: WATER Address: No address provided
Problemllssue: INSTALLAMR METER Phone Number: 5740346
Scheduled Date• 2014-06-12 Schedul�e�Time: 10:00:00
c� (p c�
ACTION NEEDED: 2014 AMR
Created by: Wendy Hiatt Date Created: 2014-06-04
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Completed b
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. City of Fridiey
Water Department
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6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
��We hereby autharize the City of Fridley and/or its oWner
employees to do what is necessary to replace the water meter. i understand that thP prope�e
is{iabte for tfie water line from the main to the premees harmie stfo ranY damjages that may occur
402.06) I aiso hoid the City of Fridley and/its empioy �� �yalls,floors or the curb
while doing this operdtion. This to include,but not limited to;valves,pip' �,
stop box and service line. I understand I am also required to obtain a permit prior ta ar�y work,if
necessary.
2.� l 3 �2� � �
Finat meter reading(old meter) �r��
Address• rDI� � �l�/
Name� �
Phone Number� Date: `.1��— -
Signature.
Witness Signature: f
"� FRIDLEY GTY CODE
CHAPTER 402•WATER,STORM WATER,AND SAMiTARY SEWER
ADMINISTRA►TION
(Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402A5.PERMIT FEE
Prior to constructing or repair of any water or sewer line connecti��s��y ben equiredto ob ain a permit for such
or building for which the application is made,the owner or contra
connection,and shall pay a perrnit fee as�a„be not fed. It shail be unlawful to cover any conr�e'cti g�in euntif an
made,the Water and Sewer Department s
inspection has been made and such connection and the work incident thereto has been app�oved by the�ty as a
propec and suita6le connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connectian has been made to the water service curb stoP ne forrconnectionl the ppl cant owner,
line or a water service or sewer(ead has been extended to the property�i
or the occupant or user of such premises shail be fiable for all repairs required to any wate�N1ner requests r��nes
necessary for connection ofa hs�P�e erformed by the CitYtthe P operty�Wne shall be charged for the costs of the
maintenance service or rep p
maintenance and/or repairs, including any necess�W�eCt o�upant or user to perform�tanda d maintenance of
po licy. It s ha l l be t he r e s p o n s i b i t i t y o f t h e a p p l�c a n ,
• the sew�r service line from the premises to the main incle d�n aa W II ensure hat t ema u i ns abave the fi ished h e
water service cur 6 stop box f o r o p e r a b i l i t y a n d a t s u c h h g
grade of the land or property. (Ref 638,1156,1191)