Meter Swap �
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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
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ACIION NEEDED:
Crcnted by: Beth Kondrick Date Crexted: 2017-04-17
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ACTION TAI�N:
,�.�.g-�-a.Ct�e.�
Status: In Progress Sabmitter Haa Been r,
Contacted
Date Completed: ��—] ��j l Completed by: C 1 ,�p�
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1,(-yrr� laer�foy au�Eho�-ize ttlae�' �#��Fd1
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�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�$�ao�8em3��t�vadves,�r�ira�,�atts,�9�aoe�s��s:d�ae�uri�sto�c&aox�rad sesvice liseea �aa�ersd�rstand�am ad
` trr o�aisa a percnit�ar�as�o an��r�nr�,s��secessarale
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Prior to cor�structirrg or�-epair o�arry watea-of�,rer�'uae cbnnecting the eatistirsg�unicipal sqstem and ar�y i�ouse us bu7ding for which tf
appticatiort is se�acte,the ormer�r cors�ractvr shall be required t�obfiairs a psrrra�t for such wnnectiara,and s(�afi oay a permr�fee as proai
Cha�rter 3.�of this Code_ �er such connection l�as beeta made,the�4'ater and Sewer Departmertt shali�e aaotified, !t shaJ!be unlawful#
ara�corrae+c�ar�g dine uer�T an inspect�ora�Sas taeen anade and such cor�nection and the s�*�rgc incident thereto has been approvQd by the Cety
pro�er and sui�tbte sonnection.
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A�ter the inr'ta'a!sonrtection t�been made�o the wafier service curb sto�a h�onc or tf�e searer�ad at�se propert��ine ar a raiter senric�e lea•
f�een extender��tc3 the grvperty line#or sonraediarr,the appficarrt,vavner,4r acaa�rarit a,r u�r c#such premises shatt be l�aa�te forall r9epair.
requ�re�to arn��rat�r line and sewer I�nes asecessary fvr cannection aF the prem'rses from�e main to the�reraises. 1f the property rnme,
reyuests mair�tenance service ar re�airs be�rerFormed iry tfse�i Cy.tfae�perty crwner shail be charged for thhe�o,sts Qf�thhe ma�rr�nance a
repairs,indudirag nese$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
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' City of Fridley
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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 ��� -
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. . Remarks• �� �p� -J�1�m�2S a�► `�tA�t
Signed � _
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