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Meter Swap ,-.. � Request Number: 14542 Public Works Division Service Request Problem�4ddress: 5312 Altura Rd Requested By: Kislrish Departme�: WA1ER Address: No address provided ProblemJTssue: INSTALL AMIt ME1ER Phone Number: 763-572-9616 Scheduled Date: 2017-04-10 5chedaled 11me: 07:30:00 �1 � c��` � ACIiON NEEDED: Created by: Beth Kondrick Date Created: 2017-04-05 ACTION TAI�N: __ ti�,S�-�1 �t✓� �- _..__ Status: In Pro�ress Submitter Haa Beea r. Co�acted Date Completed: Completed by: �� D-l� -7-- l�- � � � - 1 �� u��.,.- �-9 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 wha#is necessary to replace the water meter. I understand that the property owner is liable for the water line from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may occur while doing this operation. This to include,but not limited to valves,piping,walis,floors or the wrb 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) O �� Q Name: � JV�� U� Address � � `� ��'�v' �'' � Phone Number � `� . 1��{� Date �� O � � [ Signature Witness Signature OLD METER# �� OLD READING V !�� O NEW METER# � � vU�� 4 � NEW READING Q ERT# � �'2�2� � � FRIDLEY CITY 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 constructing or repair of any water of sewer line connecting the existing municipal system and any haase or building for whtch the application is made,the owner or contractor shall be required to obtain a permit for such wnnection,and shall pay a permit fee as provided in Chapter li of this Code. After such connedion has been made,the Water and Sewer Department shall be notified. It shall be unlawful to co�r any wnnecting line until an inspection has been made and wch connection and the work incident thereto has been approved by the City as a proper and suitable wnnection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connedion has been made to the water service curb stop box or the sewer lead at the property line or a water service lead has been extended to the property line for connection,the applicant,owner,or occupa�rt or user of such premises shall be tiaWe for al1 repairs required to any water line and sewer lines necessary for wnnection 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 maintenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility aF the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the water service curb stop box for operability and at wch height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) ;,�„, . 4 *.��_ �` �+ ,� 3 a �j. �i � � �., � � � �` R � k � ��' ��`�r� �.� " ,� " �,:_�� I�BI'�G ��r�'7' /7/�/7/, ', ' , � .,._�_.._.» Date__ �S'f" �5�� Old Meter Number �' Old Meter Reading G �`� Replacement No. � , -�'a`�-7 Replacement Reading � Replacement Make ,r r',�ar'' Remarks: /� � Signed ��