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Meter Swap � " Request Number: 14572 . Public works Division Service Request Problem Address: S21 53rd A� Requested By: Jason Kr�ger Deputme�: WA'IER Address: No address provided ProMem/issnec INSTALL AMR ME1ER Pbose Number: 763-670-4837 Scheduled Date: 2017-04-13 Schedaled 1lme: 02:00:00 � �� �- ACIION NEEDED: Created by: Beth Ko�rick Date Crented: 2017-04-06 �1C."TION TAI�N: , �� U�` � �� � Statas: In Pro ess �bmitter Haa Been r, � Co�acted Dxte Completed: Completed by: '�— l 3— ��1 � (br � :,v. �.. ��� �,�_ �����o.�o� . - Sz� � 3��� . City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 �/We hereby authorize the City of Fridley and/or 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 all iMerior plumbing. f Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for arry damages tt�at may oaur while doi�this operation. This to include,but not limited to valves,piping,walls,floors or the curb stop box and senrice line. In understand I am aiso required to obtain a permit prior to any work,if necessary. � � � D � �OV F1�11 KA�R READING(old meter) ,.: Name:�c/�,7��K �`► "�'1� Address r 7 l� ` � J�� i�'�V� Phone Number ���� ��`�� ��J�ate 4����t� Signature Witness Signature OLD METER# I� �S �� �� OLD READING 6� � O Kl ��� NEW METER# � 1 I�V v��,� NEW READING � ERT# I ��\ � ��� FRIDI.EY 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 connectiog the existing municipal system and ar�y house or buildir�g for which the appiication is made,the owner or wMractor shall be required to obtain a permit for such connection,and shall pay a permit fee�provided in Chapter li of this Code. After such connection has been made,the Water and Sewer DepartmeM shall be notified. R shall be unlawful to cAver any connecting line urrtil 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 kad has been extended to the property line for connection,the appiicant,owner,or occupaM 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 premises. If the property owner requests mairrtenance service or repairs be performed by the City,the property owner shall be charged for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibil'rty of the applicar�t, owner,occupar�t or user to perform standard maintenance of the sewer service line from the premises to the main including debris dearing or root cutting and to maintain the water service curb stop box for operability and at wch height as will enwre that it remains above the finished grade of the land or property. (Ref 638,1156,1191) �°� R�ll�St f�N�f�IiG�E: �+EF�tlI"� Ci#y c�f Fndley ��t�� s�-�2-� t�c�: s�r2oi2o�2 i�equest T�e� Sewer badc-tQ cF�edc C�t�►��ain fr�#€xed 8y: Wendy�t L�artrnenk: Sewer Ca�'zen�f�se: i� Ad�ess� 5"11 �3RD AVE NE +Ca�s�ck Ftxx�e: 7fi3-572-9�1B �uted [?ate_ t�r: L�oc�nn��is: Fi�� Deta�: Fio�eawr�e sa�s C��►f�ad�anha�le �aff and w�ere do�g sa�e�rark ar� 9/17_ Ercr�tws�e has been P��- Actio�T�c�: C�'�n� � �11.ct.v,� L'L� d�'.'r` /i/, /'7� .� (. /��,�,.� W 0� �� [ � � • � [ � i ; � i [ � I i � � � � � 1 � I � I I � , � 1 � ____ ---- --..___. _...__. _ __ . ..� Resp�ns�P+�: ���� �G�yu _ ,� / JGf}._.. . ._.. f�ver: _ _ __ __ , ��n Date. a _ � �tiz+�Nd�d 1' ' o� � la� ; ._ . __ ��� f�r�er�c.�: R��t �i�y'�rf �ridk�y �: �-��-� ��: ��� l�que�t T�_ S�E�-up ctredc{��r� i�r. N� : � ��: � lldd�es�: �1�A�/E�ME �abadc P�ne: 763�T�-�Z6 S��= P�ap�jr Ow�� - Req�ll�: #la�ea�w�er�s{�Eiad�aiate +o�anl waes�i�'ng aia�■e�edr.� 9�'1?_ C-yer sirrce lis irr�Iras been �- 7�: (�j► ' �e�,ar. . �urae � ��= _ C�tJ C�r��e: 9120V20iZ 714 Mi ��� �. � ___..�._.._�.�..�.�._.