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Meter Swap t -� Request Number: 14836 Pubtic works Division Service Request Problem Address: 5471 Altura Rd Requested By: Ronal Departme�: WATER Address: 5471 Altiva Rd Fridley,MN 55421 Problem/Issue: INSTALL AMR METER Phone Nutnber: 651-329-4400 Scheduled Date: 2017-04-2 Sc6ednled'Iime: 10:30:00 �-- �. 2�- �v� ACITON NEEDED: Created by: Beth Ko�rick Date Created: 2017-04-20 ACIION TAKEN: --�-�-����- � Status: In Progress ����r Has Been r Contacted Date Completed: Com�eted by: �l -2�� �� �" � �� r "� ���4 �u-�l ��c�- o� � So � �,�� ti ' City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 �/We hereby authorize the City of Fridley and/or its employees to do what is necessary to replace the water meter. 1 understand that the property owner is liable for the water line from the main to the premise and all iMerior plumbing. (Per City code 402.06) I also hold the C"ity of Fridtey and�ts employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. in understand 1 am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter)_ � � v /� Q SV Name: ���1 Address `'��� 1 F�G �,'llv"'v�. Phone Number_�E?�� c] (��`���l��te — 1��� t r Signature Witness Signature OLD METER# - 1 1 �� D��� OLD READING I � � !� ��Q NEW METER# �1 "I liCJ f.���� NEW READING � ERT#_ I � V� �t ` � FRIDlEY ClTY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to construding or repair of any water of sewer line connecting the existing municipal system and any house or buildins for which the appfication is made,the owner or contractor shafl be required to obtain a permit for such connection,and shalt pay a permit fee as provided in Chapter li of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notffied. It shall be unlawful to�ver any connecting line until an inspection has been made and such wnnection and the work incident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water sen�tce lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be perFormed by the City,the property owner shall be charged for the costs of the mairrtenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility af the applicar�t, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clea�tng or root cutting and to maintain the water service wrb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191)