Meter Swap �
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Request Number: 14739
Public works Division
Service Request
Problem Address: 5213 Horiwn Dr Requested By: Steren Carlson
Departmeat: WA'lER Address: No address provided
Problem/Issue: INSTALL AMR METER Phone Nnmber: 5�2-9611
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SchedWe 2017-04-20 Schedeled Ttme: 10:30:00
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ACIiON NEEDED:
Created by: Werxiy Hi�# Date Crcxt�d: 2017-04-17
ACITON TAI�N:
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Status: In Pro ss �nbmitter Has Been r
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Date Completed: Completed by:
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� �-��Slace t4�e nra�er�zeetec_ �a�aodersi:�sad�sa��€ae ro e � eiP andfor its empdo�ees fi�si��nrhat os roes
� P P ��vnes is�iai�le f�a��l�ae�ratter 9in��rom the anais���te premise and a!1 aartei
,�tsaaaa�ieag. (�����ty sos8e��Z.�6� �at.s��m9t8 Lhe�'rt�r�f�as!!ey aa�d�fis erra�fxaye�s�aaeseTPess#or any�/ara�sages�at gaaa��cctis�rfaite�
��ea�atiora. '�'O�e�s#o��fucB�p�a�t�acaR 8esa��ec!tca 9radves,�r9ping,wratls,f9�esrs as�}se�aarda sto�a kaox arad seavice lisee_ Ira ussderstand�am al
��tmt-afra a perca7it prs"or�c+,aray�ror�,a£s�ecessa�ye
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4Q2.S PEF�Rd�'FEE
Prior�o�ons�tructing vr repair af any water of sewer i�ne connecting the e�rsstir�g rnuniapat systern and arry€�se os�bu7fiirigfo�whic�#
applicatifln is made,tlae o�rner oc corr�ca+�tflr shail be required to obfiair�a�rrsait for such cnnnection,and sfralI pap a permii fee as provi
Cha�ter��of this�ode_ �tfter such cor�nectaon�as been rnade,the�U'ater and Sewea�Departmerrt shali�e�toiafied. tt shai!be un(awful#
aray cone�ecCing tine un�7 an irrspectivn i�as 6een a�nade and sucfi connectaon and the rvorAc in�iderrt thereto has kteen approved by the�ity
�ro�oer and s�aitab�e conn�stian.
4272.D6 #TEPAdI�ARt��}tA1NTE41tAPdCE Ta�OtY�fECTfUN
After�fie inil�af s�onnection has been rnade�o the wateer service curb sto�e:�oec or fi�4e sewer�ad at�fte property�iir�e ar a raDer service lea•
beerr extended to the p�vpertq iine for conraedian,the appiic�rt,ovrner;slr accvpa"r`�a�r user af such yuemises shatt be�ial�e forall rn�air.
�eqc�ired�to arry wa#er iine and sewer lines s�ecessary#or connection aF,i��,rerr��ses from the main to the�mises. If i�pro�e�f o�e,
�eqwests mai+r#enance service or repairs be perFormed 6y tfie City,l�ae prope�(,y aaevrt�r shatl be charged for the cosEs crf�e mairrtenance a
repairs,indud��ag ne+�essary stseet repairs at a rate set arsnuatly;b�an admin�ve pol'uy. (t sha�#be fii�e resporisibil"rtrj of the aP�1►c�t,
cnvner,occuparn or user tv perform standard anairrtesi�nce vE the sevrer seraice tine firom the prem�ses to the rnain andudir�g def�fis dearir
root ce��tting arad to ana�r�tain the water service curb sto�a box for Qperakeitity an�at such�eaght as mn'll er�sure ti�at it remairts a6we the fini:
gracde of the�ansd o�-property, �Re+f 63$,Z156,1192)
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City of Fridley
Water De�artment
Address �5�,3 �212U� �_
Name �J��11�1 �2L So�� —
Date ��� �'�U
Old Meter Number �� 0
Old Meter Reading �� � �(�
Replacement No. ���J`I b�
Replacement Reading �
Replacement Make ����
Remarks: �"?t�P(�� �� 1 -C z'� -
Signed �