Meter Swap �
� Request Number: 16496
Public Works Division
Service Request
Problem Address: 1343 53rd Ave Requested By: Kevin Hopps
Department: WA'IER Address: No address provided
Probiem/Issue: INSTALL AMR METER Phone Number: 763-574-0389
Scheduled Date: 2017-08-10 Scheduled'IYme: 09:00:00
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AC7TON NEEDED:
Created by: Wendy Hiatt Date Created: 2017-07-27
ACTION TAI�N:
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Status: In Progress Submitter Has Been r
Contacted
Date Completed: Completed by:
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�i��Friei9ey� �"Y `C�t7"1 /� ��/
i+l0ate��e�sart�vten�
' �431 i��aaversity Avenue NE �y,� �,r-���
� Fraslley,MN 55432 �rl
763-572-3566
rA''a� hereby authorize the City o#FridSey andJor its empfoyees to do what is necessary to
repiace the water meter. l understand that the property owner is 9iable for the water line from the main to the premise and all�r�tertor
plumbing. (Per�C'ity code 4�Z.�6) t atso hold Che City of Fridley andJits employees harmless for arry damages Chat may occur while doing ihis
operatiam. This to incBude,but not limited eo valves,piping,wails,floors or the airb stop box and senrice line. in understand t am afso require
to abtain a permit prBor to any wor[c,if necessary.
FINAL METER READING{oid meterj V�� �� � O
�ame: �L`Q�V�Y�. �U�n � Address_ 4 J�� ��r 1�-�/�
Phone�tumber ���v ��� ��3 89 pa� � '�' '� (,�
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� Signature 1•� ` . Witness 5ignaivre
r�J th'��J�(�--i � fb-fo-aS
OLD METER# � l �t� „ _ /���
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OLD READ4NG � ��� / �� �
NEW METER# _��rl�' ��1(,l.u/�.to y�/L o�✓�
NEW READlNG �
ERT#_ � � U � lQ �y�
FRIDLEY CITY CODE
Ck6APTER 402.WATER,STORM WATER AND SANITARY SE1A/ER
ADMIRIBSTRATION
(Itef Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191)
402.5 PERMiT FEE
� Prior#o�construcCing ar repair of arry water of sewer line wnnecting the existing municipaf system and arry house or buiidir�g for which Che
application is made,the owner ar contractor shall be required to obtain a permi�for such connecCion,and shafl pay a permit fee as provided in
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departmerit shal(6e notified. It shal!be unlawfui to cover
any conttecting line until an inspection has been made and such carsnection and tfie work incident thereto has been approved by the City as a
proper and suitable connection.
402A6 REPAIRS AND MAINTENANCE TO CONNECTION
After the initiat connedion has been made to the water service curb stop 6ox or the sewer lead at the property line or a arater service fead has
been extended to fihe property line for connection,the applicarrt,owner,or occuparrt or user of wch premises shall be i(ab(e for ali repairs
required to any water line and sewer lines necessary for connection of the premises from Che main ta the premises. If the property owner
requests mairrtenance service ar repairs be performed by the City,the property owner shall be charged for the costs of the mair�tenance and/ar
repairs,inctuding necessary stre�t repairs at a rate set annuaity by an administrative policy. It shall be the responsib�lity of the appiicarrt,
owner,occupant ar user to perform standard maintenance of the seuver service line from the premisQs to the main including debris ctearing o�
root cutting and Lo maintain the water secvice curb stop hox for opera6ili#y and at such height as will ensure that�t remains above the finished
grade af the(and ar property. (Ref 638,1156,1191f
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city ot Friaiey
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.. Address � . � � .�,� � ', _ _ _
,. Name 4 , _ _:_ _
Date 1(7 � �O_,/ ��- , _.
Old Meter Number ,�7 � � � �
Old Meter Reading / cO � � -.
i Replacement No. � �J�
Replacement Reading�_
. ; Replacement Make__5:.�� a�'� -
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. . Remarks: �/ �'c'�<S� G P� �"��°� , _
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