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Meter Swap S i s Request Number: 15239 Public works Division Service Request Problem Address: 187 Panorama A� Requested By: Matt Department: WATER Address: No address provided Problem/Issue: INSTALL AMR METER Phone Number: 612-760-0203 Schednled Date: 2017-OS-17 Schednled 13me: 09:OU:00 �� AC'tiON NEEDED: Created by: Wendy Hi�tt D�te Created: 2017-OS-09 ACIION TAKEN: — �'^ \ �� !``V`_�'�.-.--___.....__.__..._._.—._... .___..._._._..._ .._... . Status: In Progress Snbmitter Has Been r Contacted Date Compteted: Completed by: � ��J_ �� /vt, YUY�� l y , . City of Fridley �„/ � (,�Tj � �3� — �� Water Department G�� 6431 University Avenue NE � � � I� O Fridley,MN 55432 � � 763-572-3566 �/We hereby authorize the City of Fridley and/o�its employees to do what 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 ali interior plumbing. (Per City code 402.06) i aiso 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 vahres,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) �� 4 Name: 1- W1�� Address � �� Pa�►�� Phone Number�SJ i� RL�IJ�� Date �� Signature � YY'Kness Signature OLD METER# �r�J"1�- i � �� OLD READING ��/ 1 �vO NEW METER# �� 4 � � NEW READING � ERT# � 1 ��lJ `� 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 house or building for which the application is made,the owner or contractor shali be required to obtain a permit for such connedion,and shall pay a permit fee as provided in Chapter ii of this Code. After such connection has been made,the Water and Sewer Department shall be not�ed. It shall be unlawful to cover any connecting line until an inspection has been made and such connection and the work incident thereto has been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water servke lead has been extended to the property line for connection,the applicant,owner,or occupant or user of such premises shall be liable for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premtses. ff the property oarner requests maintenance service or repairs be perFormed by the City,the property owner shaii be charged for the costs of the mairrtenance and/or repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. It shall be the responsibility of the applitar�t, owner,occupa�t or user to perform standard maintenance of the sewer senrice line from the premises to the main including debris clearing or root cutting and to mairrtairt the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,3156,1191) R�quest for �ervice R+��rt City of Fridiey ��r�: s�-�2-�a��s o��: �+7�,�rtz � T�� s��►�� d ay: w�iy��t [�partm�: Sew�er Catiz+en t�a�me: 14c1dress: 1fY7 P1�11�OMRN�1�1 A�/E C�rac�c Phc�e: Sch��d Date: Pmpeity Orwn�r: Loc�ori f7eta�ls: F�equest �etails_ Ba�e up_ Ct�ec.ic Cat�r�ein ;4etic�T�c�n: R S � a �., V t,�0 '. ''� C� �1-� �-�-� /t , � � �,eS�-or� �u�(eJt .�,v d�o C ��,;,� _ vQ _ �lo )�..�- 'wc �l�' h. o� �ra� '"1 V �� A�r�l' �'�^-�`1� �lec�r�z�� C ct i l �'l'�t�►'l ��iti ��ci C. (e cx r� � ` �w,e./�� f � � � � � � ` � __ .___._..__...____—_-_____._..___._____� Respau��e Pers�r-i: ��= � � _ _ _ _ _ �am�ion I7�e: /�t�.izen�la�+et� � -- 18 -- � � ��# f�r�erv�e R�p�rt ��y c�f �ri�il�y ��d�ka: �-12-443� �: 3r"19l2�12 �equest T�pe� Se�6adic��in �e��a: VN �� 1�7 FAI�(?F�MI�� . �d ll�e: �t�w�: . H� �j+. �iequ��atai�s: B�c ya_ C#�t3t�w� �►��:�qp� T . �i�t t�r�� 24R�caie�t�+�c�san t�. Ft�awa�uid nd�a�r r�in�_ +CaA�raia�6r�g�u dean ae�rer. � � � s � � � � 1 � � 3 3 1 i � � j I � � � � ____....�_.. � � �� ' � � � €�: ��.r��2�-.�t ata t�� . .___ _...�_ ....____ �_.__