Meter Swap �
t Request Number: 14852
Public Works Division
Service Request
Probtem Address: 137 49th A�e Requested By: Karen
Departme�: WA'IER Address: No address provided
Problem/Issue: INSTALL AMR METER Phoae Number: 763-572-1517
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Scheduled Date: 2017- 4-25 � Schednled Time: 09:00:00
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ACIION NEEDED:
Created by: Beth Kondrick Date Created: 201'1-04-21 ''"�'R�
ACITON TAKEN: ,✓^,
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Status: In Progress Sabmitter H�Been r
Co�acted
Uate Completed: f��^�J �� Completed by: ` t
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�'��4ace t4��+Ara�er�raeter_ ��aa�s8erstaast!i�a��Eae prd�eaty srwnes is diaf�le fmr�lae�►+ater die��`rom the�nais�to�tPae premis�a+zct ail a�tea
�Vaarra�sr"eag. �AAr�C"sty�ode 4�2.�II6� �ads��t�ic1�e�i�jj�#�se�le+,+�d�"r�s erra�lmyees ltasmless fos a��afatages ttaat rraay sacca�s^3or�aile s�
� �wea�a�iara_ �'4ais���nefucfe,��,yt�ao�8asa�ated�sialues>�sPing,wadls,f9oors�s td�ae sa,cr8�sto�n kaox�rad servece Jisae. !ra�esderstand�am a!
ts�o8a�aira a pea�aaiL prs"os to�aeay w�nr�,'sF ner,essarye
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�rivr to cons�ructirrg or�epair of any wafies aF sewer 9iaae connectirig tfie ewsting muniapal sysfiem and any[wuse os bu�for whir�t#
appls'catian is a�nade,fihe owner or corefiractvr shail be required to obfiain a perrr��for such aonnectw�,and shali pap a g�errr�fee�prrnri
C�Sa�rter 3.�of#his�ode_ After sunc�onne�on�as been rnade,�te�4'ater and Se�wer Departr�aent shaJt be no�sfied. tt stta[!be urttawtvl t
arry cox�necting Cne urrta'!an inspectivrt has been made and�,rch connedaon and tk�e rrrorh insaderrt thereto has beert aPproved by'the Crty
pro�oer and suit�abte connectiora.
4l72.D6 �tEPAlRS�tltD lwtA1�[APOiCE i'Q C�ECTd�4h(
Ai=ter the anr'ts'at r.onnection fras b�en made to the water seruice curb stop bo�c or the sewer lead at�e property iine or a rra�r�raice lea
been extended to�e prv�erty line#oc conraectian,the appiicarrt,aavner,or accupar�ar ru�r of such�emise�shalf be!'aiab�te far atl�►air.
require�to arn�water iine and sewer lures e�ecessary#or c�onr�ectiorr aF fifre�rernises frorr�the mairr to the�remise� tf the property rnme�
requests mairr�enance senrice or repairs be AerForrned by the Crry,�fae�aroperty aarn�r shafi be d�erged for the�osts of t6e mai�ce a
repairs,in�uding rtecessary srtreet repairs afi a rate set annua�hj 3r,�an adrniniskra�ive poPscy. It sha(t t�e fihe s�espor��6ii"rty of the a{�1'ic�t,
vwrasr,occupa�fi rar user to perfvrm standard anairrteriance aF the sewer seraice�ine from the premises to the anain dndurc�r�deb�is c�ea�irs
rQat�zziting ared�o maisrtain the vrater service curb stog 6ax for operab'slity and at scich�eight as�nl!eruure that�t remairis a6ove t�te finc
gra�e of#he dand or property, (Ref 638,1�6,119��
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�-77`�s`t�f7�1�
City of Fridley
Water Department
Address ( � / ��T� � �J
Name s ��'�i� �'� _
Date ( � — � ~ � �
Old Meter Number / � L �
Old Meter Reading � � � ��
Replacement No. �� � ��1�
Replacement Reading
Replacement Make���
Remarks:dl!✓� �`C"� �` vs�'�" �^^�'KB
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Signed —
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