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Meter Swap � � Request Number: 14720 Public works Division 5ervice Request Problem Address: 115 Crown Rd Requested By: Xander Broeffle Department: WA'1F,R Addreas: No address providcd Problem/Tssue: INSTALL AMR METER Phone Number: 218-590-3618 Schednled D�et • 2017-04-2 Schedeled 1lme: 02:00:00 .� ,� � r-,� ACIION NEEDED: Crcnted by: Beth Kondrick Date Crexted: 2017-04-17 � ACTION TAI�N: ,�.�.g-�-a.Ct�e.� Status: In Progress Sabmitter Haa Been r, Contacted Date Completed: ��—] ��j l Completed by: C 1 ,�p� °` I �,�4l,ti�iV _ �,� �r� "��.;. � ., � ��� � 1,(-yrr� laer�foy au�Eho�-ize ttlae�' �#��Fd1 �e�O9�ce t£�e nra�er�zeetea�_ �a�saderstaead�.�Sa��tae �o e '� �9 arad/�r its zrnpdogees�s!o+nr�at ss nec, �s�s�a'rabirag- ��A��- � P �'ownes��s�ia�sle foa��ae�rater fin��rorse�he�mais�tc��e premise and a31 earte� �t+f sode 4�2.��� �a�s��a�i+d the�"sijj�f�sas�ley and�"rts�are�l�ees�asmiess for eray�lamages�aat rraay�cca��3uhile�!� ' �,eaes'sYia�e. Shis���cluctep�a�$�ao�8em3��t�vadves,�r�ira�,�atts,�9�aoe�s��s:d�ae�uri�sto�c&aox�rad sesvice liseea �aa�ersd�rstand�am ad ` trr o�aisa a percnit�ar�as�o an��r�nr�,s��secessarale IaS- 45��d-a3 �Qt�tA��iiETE6i€kEA�NwCa�a�meterj �/ � �� �O� �� � � 10iame: /"�,V\.(�`Q� �1�(J'et t'"�'� A�{dress ��_��f't, � Pf�one Alumis�r�l �}" 5-C Q `3 C2 1� Oafie - t' �'J '�" I l S"�gnatsxre ������� ������ �3 3� g�C��L�� ���t��__ d�,�D � c� ��������_'�q a,c� ��3 � � �� v ���� ���� 3 ►� � . ����C��� �����.�A��,����.�������S� ������� ���o�r�o sz�0 as�y�s�,�ss,�z�,�3s,��zy�2,gss9�a.�,ss��,as�z� 4Q2.5 PEfil4ftd'0'FE£ Prior to cor�structirrg or�-epair o�arry watea-of�,rer�'uae cbnnecting the eatistirsg�unicipal sqstem and ar�y i�ouse us bu7ding for which tf appticatiort is se�acte,the ormer�r cors�ractvr shall be required t�obfiairs a psrrra�t for such wnnectiara,and s(�afi oay a permr�fee as proai Cha�rter 3.�of this Code_ �er such connection l�as beeta made,the�4'ater and Sewer Departmertt shali�e aaotified, !t shaJ!be unlawful# ara�corrae+c�ar�g dine uer�T an inspect�ora�Sas taeen anade and such cor�nection and the s�*�rgc incident thereto has been approvQd by the Cety pro�er and sui�tbte sonnection. 4tlZ.05 5{EP�tRS ARttD 91�td14YTEN1�'�94iCE i'fl�C'DtYAfEC17t�J A�ter the inr'ta'a!sonrtection t�been made�o the wafier service curb sto�a h�onc or tf�e searer�ad at�se propert��ine ar a raiter senric�e lea• f�een extender��tc3 the grvperty line#or sonraediarr,the appficarrt,vavner,4r acaa�rarit a,r u�r c#such premises shatt be l�aa�te forall r9epair. requ�re�to arn��rat�r line and sewer I�nes asecessary fvr cannection aF the prem'rses from�e main to the�reraises. 1f the property rnme, reyuests mair�tenance service ar re�airs be�rerFormed iry tfse�i Cy.tfae�perty crwner shail be charged for thhe�o,sts Qf�thhe ma�rr�nance a repairs,indudirag nese$sary stretreet repairs at a rate se�C aanuai(y bp an admin�e pofcy. �t shait be the resporisbility o#the aPp���, awner,occupa�or user tv perForm standard mairrtenance of fihe sewer service line from i�e prem�ses to the main indudirig debrts dearir raot�,za�tCing and to mairrtain#t�e water service aarb stop box for oper-ai�ility an�afi such�eight a�s mdli ensure that it remains above i;hhe i3ni: grade of fihe laa�d or property. �Ref 638,Z�56,1191j 7 -- ------- , ' ���� � _ . � � � ���� �� � ; � ��� � � � � � � ; ' City of Fridley , Water Deuartment � . Address � t� �,.,�1�t3 � . Name !�c��AJ 1�t'1't�� } _ Date � � , Old Meter Number ��� t o��Jo� ; Old Meter Reading I �� � Replacement No. �•�� C�� ��� Replacement Reading � ; Replacement Make ��� - � . . Remarks• �� �p� -J�1�m�2S a�► `�tA�t Signed � _ . . ... _ , �_ _._ _ _. _ . _ __.