Meter Swap �
i Request Number: 14742
Public Works Division
Service Request
_____�.____ _ �.__ -- - �
Problem Address: 5139 Horizon Dr Requested By:
Department: WA1ER Address: No address provided
Problero/Issue: INSTALL AMR METER Phone Number: 651-263-4819
Scheduled Date: 017-04-20 Schednled'I'ime: 07:00:00
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ACIIOAT NEEDED:
Created by: Beth Ko�rick Date Created: 2017-04-17
ACITON TAI�N: �
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Status: In Progress Submitter Has Beea r
Contacted
Date Completed: Completed by:
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t�o8a�aisa a�rercnit�Sr�o�r�o ara��r�e�c,a�necessarq�e
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Prior io constructing or repair of any�er af sewee�iirae connectir�g the ercistir�g mtrr�Pc;�ai systerr�and any�touse v`�7dfrrg fos whirJ�t tt
app�icafiifln is ex��de,tJae osvner or cor�tra+ctor shalt be required to otrtairs a perrrsit fvr such cormectivn,artd.st�ll pay a permit fee as psrovi
Cha�ter�rrF thfs Code_ After such cosrnec�ion�as beera made,ifte�Yater and Sewec Departm+ent�att be raat#ied. tt shan be un{awfia!#
aray coranectang�ine urrta7 an ins{�ectian has been rnade and such conaectavn anst the wQrBc inciderst thereto Etas beere apProved by the Crty
pmper and suitab�e conneetiora.
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�lfter the inii�a)sonnection has been made�the xrafiec serv��re curb sfio�e b�c ar ti�e serrer lead at�se propertY iine�a�ra6er xrtrice�
taeen exfiended to�tfse property line for conceedion,the appficart,ovrner,qr accupaat�r user af such premises s(�ati be 1iat�e fvrall repatr
�ec�uired to arry wat��ltne and sewer lines a�ecessary#vr conr�ectian of che�remises from the maln fio the�rernis�s. lf tfie properEy arme�
a�eqc�ests mair�tenance service or s�pairs be perFormed by the C'rty,�Fae�►roperty tmrrrer shai!t1e r�arged fot�FFtte�osis o#i�e matrrt�nanc�a
repairs,inducli�ag ne+cessary street repairs at a+aCe se�t arrrtuaaly 3ry arr adra�inis�a�,�pvlicy. fit s6at#be the a�spor�sibit�o�f the appGcarr�,
o�vner,occuparrt�r user��rerfarsn stansiaa�!arsairrteriance of�tf�e se�wer sererice line frorr�fihe premises ta the main indut6�detu�dea�ic
r�crfi sza�ing ared to ma�rrtain the water service cari�sfiop box for operai�ility ancd at such i�eight as an71 ensure that it remains a6ove the fini:
gsade of the laa�d or�trope►'tY- �Ref G38,1�556,1191}
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City of Fridley
Water Department
. Address .� �3 1 1'�lr,i�i1. Ll�_
Name �S �/�,� •
Date 3��V ��V
Old Meter Number � ,J� �
Old Meter Reading � D
Replacement No. �p �� ��� �
Replacement Reading �
Replacement Make_�_��-Pi�
Remarks: �
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. S igned� !'J�
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