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Meter Swap � Request Number: 14643 Public Works Division Service Request Problem Address: 5380 4th St Requested By: FROILAN VELEZ Department: WATER Address: No address provided Problem/7ssue: INSTALL AMR METER Phone Number: 763-572-2664 Scheduled Date: � i� � �� Scheduled'Iime: �� h � � ACTION NEEDED: �� Created by: Beth Kondrick Date Created: 2017-Q4-12 ACTION TAKEN: _�.�___._._...........................__............:.:�_��,��.�..................._._._��'.�-................................._..__......_.........................._.__.__...._................__......_.�.._..___._..___....... ::��--��, Status: In Progress Submitter Has Been �, Contacted ''`'` Date Completed: �� `� Completed by: �� _� � �t �` � �� r ��.. �� City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 1/we hereby authorize the City of FrPdley and/or its employees to do what is necessary to replace the water meter. 1 understand that the property owner is liable for the water fine from tfie main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmiess for arry damages that may occur while dang this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand 1 am also required to obtain a permit prior to a�y work,if necessary. FINAL METER READING(old meter) � 4� � � �� Name: r'"C7?l,�0.� �'E�,p'Z�, Address � � �/d �� . Phone Number_�� `�� a�Gw� pate — I— � V ^" �' ` �� Signature Witness Signature OLD METER# ` " 1 /� �� OLD READING D I� � "�� NEW METER# t )� � �+ V NEW READING � ERT#_ G ��1 I J�D FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRA710N (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 arry water of sewer li�e connecting the existing municipal system and arry house or building for whith the application is made,the owner or cor�tractor shall be required to obtain a permit for such wnnection,and shall pay a permit fee as pro4vided in Chapter 31 of this Code. After such connection has been made,the Water and Sewer Department shall be�otified. It shall be unlawful to co�r 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 seroke lead has been extended to the property line for connection,the applicant,owner,or occupant or user of wch premises shall be Ifable for al!repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the C'�ty,the property owner shall be charged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set a�nually by an administrative poliry. It shall be the responsibtlity of the applicaM, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or root wtting and to maintain 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 638,1156,1191) UT300I01 CITY OF FRIDLEY CXI,IB 7/19/10 Customer/Location Consumpti History Inquiry 16: 48 : 53 Customer ID: 15245 Name: ZIMME , JOYCE Locntion� ID: 458480 Addr: 5 4 ST NE Cycle/Route: 02 01 Amount due: S .�Ob � Initiation date : 4/04/84 Pending : $ . 0�� Termination date: 7/19/10 Customer status: A Customer/Location status:� Type options, press Enter. 1=Select 5 View detail 6=Display comment codes Service Resding Actual Actual Meter Est Cmnt Opt Code Type Date Consumptioa Demand Days Number CD CD WA REG 3131/10 13. 00 . 00 90 7453215 WA REG 12/31/09 15. 00 . 00 92 7453215 — WA REG 9/30/09 19. 00 . 00 92 7453215 — WA REG 6/30/09 12 . 00 . 00 91 7453215 WA REG 3/31/09 7 . 00 . 00 90 7453215 � WA REG 12/31/08 7 . 00 . 00 92 7453215 WA REG 9/30/08 12 . 00 . 00 92 7453215 — wA REG 6/30/08 9. 00 . 00 91 7453215 + F3=Exit F5=Print history F6=Meter inventory F7=Meter svc info F8=Pendinq/history trans F9=Budqet trans F24 More keys � �v �,�,�.�-. ��C 7-�-� �� l� • ��-r- �-r� 1 � 3��`- � !e (a-- C��3T 1��3 ___-- ..._..- - ".^.,�"�'_ _, - _ . . .� � �G4��8J .�' Ci4�y of Fridley Water Department Address �� "� Name �Y D � ' a1/� V� �C'Z Date � 'd�� Old Meter Number �� — Old Meter Reading 33 �� '� � Replacement No. �,� ✓ll ` � � Replacement Reading �— Replacement Make�� d1�� Remarks:�/�� y�'1�'`-" Signe � � ��L-�" f e