Meter Swap ��,a�� '
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�,� i� De�ar ffient'
Address �� � � �„��_��
Name S�-C �'^w G�-�P .
Date / t�``U �`
nld Meter Number
ls`7 !' � ��
�1d Meter Reading � �d -
Replacement No. � ���� � �
Replacement Reading 0
Replacement Make_,�,��''��
Remarks: � l Y'��� ���'�
Signed �� _^`" -
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Request Number: 7967
Public Works Division
Service Request
Problem A�ddress: 5837 Washington St Requested By: Tedla
Department: WATER �dress: No address provided
Problemllssue: INSTALLAMR METER Phone Number:
Scheduled Date: 2014-06-03 Scheduled Time: 08:00:00
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ACTION NEEDED:?�CSAMR List
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Created by: Wendy Hiatt Date Created: 201406-02
ACTION TAKEN:
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Status: In Progress Resident Contacted ❑
Date Completed: Compteted by:
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. � . City of Fridiey
r
Water Department
6431 University Avenue NE
�� - Fridley,MN 55432
(763)572-3566
��We hereby authorize the City of Fridley and/or its owner
empfoyees to do what is necessaN tQ replace the water meter. I understand that the prope�e
is liable for the water line from the main to the p�emise h��ess v ranY damages th maY oc�ur
402.06) I also hoid the City of Fridley and/its employee3 �115�fl��or�e�urb
while doing this operation. This to include,hut not limited to;�����p�p���p�or to any work,if �
stop box and service line. f und�rstand I am also required to obtain a pe
necessary. �,��� ���
Final meter reading(old meter) ���� ����_��
Address:
Name� 1 �
. Date: � �' `�
Phone Number .
Signature: '� �
Witness Signature:` -
FRIDLEY GTY CODE
CHAPTER 402.WA7ER,STORM WATER,AN�SAN�TARY SEWER
ADMINISTRA'T�ON
(Ref Ord No 113,464,565,566,629,638,662,922r 988,1144.1156,1591)
402.05.PERMIT FEE �
Prior to constn.�cting or repair of any water ar sewer<i�e CQcontracto shall ben equ redtoiob ain a pem�d fi 0 such
or building for which t he app iica ti o n i s m a d e,t h e o w n e r o r
connection,and shall pay a permit fee as provide not fed.tlt shall be unlawful to cover any conne icti g���euntil an
made,the 1Nater and Sewer Department shall be roved by the City as a
inspection has been made and such connection and the work incident thereto has been app .
prope[and suitable connedion.
402.06.REPAIRS AND MAINTENANCE TO CONNECTION
After the initial connection has been made to the water service curb�0P'ne forrconnection'the appl cant owner,
line or a water service or sewer lead has been extended to the property
or the occupant or user of such premises shall be liabaen to theepe'misesulf t e p operty owner requests r�ines
necessary for conne c tion o f t h e p re m i s e s fr o m t h e m P
maintenance service or repairs be performed by the City,the property owner shal l be c ha r g e d f o r t h e c o s t s o f t h e
maintenance and/or repairs, incfu ding any ne c e s s a ry s t r e et re pairs,at a rate set annualiy by an administrative
oli . It shall be the responsibility of the appficant,awnes,oc�upant nr user to perform standard maintenanc e o f
P �Y
• the sewer service line from the premises to the main includ�n ad wlll enlsure hat t emca ns above the fin�shed e
water service curb stop box for operability and at such he g
grade of the land or property. (Ref 638,1156,1191}