Meter Swap l 68�5-4��-It��
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Request Number: 9311
Public Works Division
Service Request
Problem Address: 6220 Rainbow Dr Requested By: John Holm
Department: WATER Address: No ad�ess provided
Problem/Issue: INSTALL AMIt ME1ER Phone Number: 763-571-8584
Scheduled Date: 2014-11-03 Scheduled'ISme: 09:00:00
ACTION NEEDED:AMR Install
Created by: Cheryl Pellegrin Date Created: 2014-10-29
ACTION TAI�N: x �
Old meter#19452993 Old reading: 56 70 New meter�3sed�t�l�aas ERT#35171663
Status: Completed Resident Contacted I"'`
Date Completed: 2014-ll-03 Completed by: Ryan Johnson
Hours
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Request Number: 9311
Public Works Division
Service Request
Problem Address: 6220 Rainbow Dr Requested By: John Holm
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMRMETER Phone Number: 763-571-8584
Scheduled Date: 2014-11-03 5chedWed Time: ��:00:00
ACTION NEEDED:AMR Install
Created by: Cheryl Pellegrin Date Created: 2014-10-29
ACTION TAI�N:
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5tatus: In Progress Resident Contacted [�
Date Completed: Complete@ b :
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- City of Fridley
. ,_. . ., �-., W��r Dppartment _ --
6431 Uni�ersity Avenue NE
Fridley,MN 55432
(763)57Z-3566
I/we hereby authorize the C�fi+��diey and/or its
. employees to do what is necessary to replace the water meter, i understand that t�e prraperty owner
_
�s liable for the water line from the main to the premise and all interior plumbing. (Per City code
402.05) I alsa hold the�ity of Fridley and/its employees ha Irm�ess or any amages ma -
while doing this aperation. This to include,but not limited ta;valves,piping,walls,floors or the curb
stap box end service line. i understand I am also required to a6tain a permit prior to any work,if
necessary. ,
Final meter reading(old met�r) ���� 1�v
Name: Address: ���`� �C�� �
Phone Numbe � Date: <� �f`�
Signature:
Witness Signature:
..
FRIDLEY CITY CaDE
4Q2.WATER,STORM WATER,AND SANITARY SEWER
ADMINISTRATION
(Ref Ord Na 113,464,565,566,629,638,662,922,985,1144,1156,1191)
40Z.05.PERMIT FEE �
Prior to constructing or repair of any water or sewer line connectingthe existing municipal system and any house
or building for which the application is made,the owner or contractor shall be required to ohtaln a permit for such
cannection,and shall pay a permit fee as pravided in Chapte�11 of this Code. After such connectian has 6een
made,the 1Nater and Sewer Department shafl be not[fied. it shall be unlawful to cover any�onnecting fine until an
fnspection has been made and such connection and the work incident thereto has been approved by the C'ity as a
praper and suitable connection.
402.06.REPAIRS AND MAINTENANCE TO CONNECiION
��b�Q����ba�oo��,ar�P r�the water service curh stoa bnx or the sewer lead at the propert�
line or a water service ur sewer lead has been extended to the propertyline for connection,the appiicant�owner,
ar the occuPant or user of such Premises shall be liable for all�epai�required to any water line and sewer lines
necessary for connection af the premises from the main ta the premises. if the prop�tty owner requests
maintenance service or repairs 6e performed by the City,the propeity owner shall be tharged for the costs of the
. maintenance and/or repairs, including any necessary street repairs,at a rate set annually by.an administrative
policy. It shal)be the responsihil'rry of the applicant,awner,occupant or user to perfarm standard mafntenance of
• the sewer service line from the premises to the main induding de6risclearingflr raot cutting and to maintain the
water service cur6 stop box for operabifity and at such height as wi�ensure that it remains abave the finished
. . . .. .. . .... .. .. .,. ..
.,grad"e of't'r�e land orprnp�rfy.�(Re€63o,-Z�S,.l�n3:� _. --