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Meter Swap � r� Request Number: 14781 Public Works Division Service Request Problem Address: 4965 Roman Rd Requested By: Afshima Depnrtment: WATER Address: No adckess provided Problem/7ssue: INSTALL AMR ME1ER P�one Number: 651-338-1435 Scheduled Date: 2017-04-24 Sc�eduted 11me: 09:00:00 � AC'IiON NF.EDED: Created by: Wendy Hiatt D�te Created: 2017-04-19 ACIION TAKEN: � � � �..�__���� _....._..._._._.__..._____ -�-�..s.._. _.�...�....._..... _____._ Status: In Progress ���er Has Been r Cot�tacted Date Co�pleted: ��, �� _' � Completed by: ( �� J ; # t p� �. �{S�S��� �d2- City of Fridley � � 3�,!�/ Water Department `'C��S 6431 University Avenue NE �'i Fridfey,MN 55432 763-572-3566 �/We hereby authorize the City of Fridley and/or its emp{oyees to do what is ne' .to replace the water meter. I understand that the property owner is Itable for the water line from the main to the premise and a111rKe��` '� plumbing. (Pe�City code 402.06) I alsfl hoki the C'�ty of Fridley and/its employees harmtess for any damages that may ouur while doing this operatior�. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. i�understand I am also required to obtain a permit prior to arry work,if necessary. FINAL METER READING(old meter) � �`�" � ��� Name• �����Y,�� Address _ � I LL� �,�91I�L��. �"C1 . Phone Number f�51 — r l U V v��� � Date '�— ��r `� Signature Witness Signature OLD METER# f < �.� � � G� OlD READING ��� ( � l � NEW METER# I I 0'`-� ��� � NEW READING O ERT# ��� 0�� l l � FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMfNISTRATION (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 haise or building for which the application is made,the owner or coritractor shali be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter li of this Code. After such connection has been made,the Water and Sewer Department shall be notified. R 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 senr�lead has been extended to the property line for connection,the applicant,awner,or occupar�t or user of such premises shali be liabie for all repairs required to any water line and sewer lines necessary for wnnection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the Clty,the property owner shall be charged for the costs of the mairitenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicar�t, owner,occupant or user to perform standa�d maintenance of the sewer service line from the premises to the matn including debris clearing or root cutting and to maintain the water service curb stop box for operability and at such height as will ensure that it remains ahove the fi�ished grade of the land or property. (Ref 638,1156,1191)