Meter Swap t t �Ci����rsd�E� `7(j� T��
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, Fra�I�y,61►1Rt 5 s432
7�3-5�2-3556
�J'�e heseF�r�authorize the Cifiy ai�Fridfey aced/or sts emp9cyees ko�lo avhat is aeecessasy tc
a���iace the uratax aneter. i a�nderstand that the�mperty o�vunee�is 9iable for�he avater 9ine from tt�e�main to#he prernise and ell irate�ior
�lue�abirug, {psr�ity code 40Z.06� �aiso hold the C'�ty�f Fr�dley andJits employees harmless#mr arry daea�ages that qnay occur while doing thu
operation, '�his to include,��st not limited�o valves,pipirsg,mratts,#Boors�r the curb stop box a�d senri iine, dn undapstand 9 am also v�equi
to�btain a perani��raor to any w�rfc,+f�ecessary. .,-. .. �.
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�fM�NtEl'�E6t READlWG o!d meter �� � b � ��.�--�--�'f
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A[arrte• ` Y.l�l;� ���e Address 5 I'�� 3�� �'
. Pho�e 9Yumber �t�.�- � �-e�'�, �-- `7-l�
Date
f.
ignature Witness Signature
OL� 311fE3'�R# _ 1� 6 V � " � ` � � ` [O (��t-r / � � �`�^�'�•.
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�L� READ9NG ��a v � ----� D{0�. yVtl�s"'�N'�
����,�-�R# '� �35 5 ���7
iVE91l�R,EADlNG �
ERT## �� G �. ��7 �'C�
�RIDLEY CfTY CODE
�HA�'CElt 40F.1NATE9�,ST�RN�WAT�R�D SAN4YARY SEWER
�AaMiN45�'RAl'fON
(�ef Orsd No�13,464,565,566,fs29,538,66Z,922,�88, 11�l4,13.56,1191�
402.5 PERNfR FEE
� Frear to�onstructing ar repair o#arty�nrater of sewer iFne connecti�ng the existing municipal system and any house or bui(ding for whic�the
application is rnade,the owner or corrCractor shali be required to ohtain a permit for such conrtection,and shafl g�zay a permit fee as provided ir
�hapter 11 of tF►is�ade. After such connection has been made,the Watev and Sewer Departmerrt shail be notified. !t sha41 be unfawfvi ta cow
any connecting line urrti[aa inspection has been made and such connection and the work incident thereto has heen approved by the Cfty as a
�roper and suitable mnnection.
Q�02.06 REPAiRS A�1iD 14lAiNFEf+IAfYCE T�CONitfECTiON
After the initiai connectiort�as been made to the water service curb stop�sox or tiae s�wer i�ad at tf�e praperty line ar a wrater service iead t�as
been extended to tFre property 9ine for cannecfiion,the appiicarrt,owner,ar uccuparrt ar user of such premises shalt be liai�le for ait repairs
rsquired#o any arater tine and server fines necessary for cortnection of tfie premises from the main ta the premises, tf the properCy awner
requests mairrCenance service ar cepairs be performed by the�City,the property oarner shail be charged for the aosts af the mairrtenance andJo
. repairs,including necessary street repairs at a rate set annualty by an administraqve paiicy. It shalt 6e ifie res�onsibitity of the applicarrt,
owner,flccupant cr user to perform standard mairrtertance of the sevorer serrice line+Fsom the premises to the main including debris clearing ar
root�utting and to maintain the+arater service curb stap box for operahiiity and at such height as wil{ensure Chat it remains above the�nished
grade of fihe Sand or property. (Ref 638,1156,1191j
, �
Request Number: 16567
4
�lC wOYkS�1VIS10Il
Service Request
Problem Address: 5143 3rd St Requested By: Nizar Benhaj
Department: WATER Address: No address provided
Problem/Issue: INSTALL AMR ME'IER Phone Number: 612-703-6466
Scheduled Date: 20 -08-07 ,,.� Scheduled Time: 07:30:00
,3,
�i N�F,�: ,�'ao�to S#41 3r�t�C a�d t3�s o�r t�ll tak,e yo�ower to 5 Z#3,3sd St as x�at is�e tb�e�r
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Created by: Wendy Hiatt Dnte Created: 2017-OS-03
ACITON TAI�.N:
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Status: In Progress Submitter Has Been r.
Contacted
Dnte Completed: � �� ,1 Completed by: ���
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