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Meter Swap a ` Request Number: 14822 Public Works Division Service Request Problem Address: 540 53 1/2 A�ne Requested By: Gary Walen Department: WA1ER Address: No address provi�d Problem/Issue: INSTALL AMR METER Phone Number: 763-572-9030 Schednled Date: 2017-04-26 5chednled'Rme: 09:00:00 � ACIION NEEDED: CreAted by: Beth Kondrick Date Crexted: 20I 7-04-20 ACTION T . ! �.s � 12 __._.�__ .__ ._�...............___._�..1�._._..�.....____._....____._._._ _ __..�_.�.___._..___ �__.. �.�,�. Status: 1n Progress Sabtn�tter Has Beea r, Contacted Date Completed: Completed by: 'i�' L�-Jl� ' 4� � ""� � ,_ - . . �� ��-r}�� ` � � , � �, i � City of Fridley ����'� Water Department S(�� 6431 University Avenue NE Fridley,MN 55432 763-572-3566 I/we hereby authorize the City of Fridley 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 Iine from the main to the premise and all interior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may o�r while doing this operation. This to include,but not limited to valves,piping,walis,floors or the curb stop box and service line. in understand I am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) � �I �'� v Name: � V v a� Address_ �`�1,O �� �2 �l�/— Phone Number � �C/����� /�./�e � �� Y ( Signature Wkness Signature���/ � � OLD METER# � � � � � 1 � � OLD READING I 2 � � ��� NEW METER# __ �� �J4.J � ��y' NEW READING � E�# �122 2 �2 2� FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATIOPI (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) A02.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for whid�the application is made,the owner or wrrtractor shall be required to obtain a permit for such connection,and shall pay a permit fee as provided in Chapter il of this Code. After such connection has been made,the Water and Sewer Department shall be notified. It shall be unlawful to cover any connecting line until a�inspedion has been made and such connection and the work incident thereto has been approved by the City as a proper and witable connedion. 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 service lead has been extended to the property line for connedion,the applicant,owner,or occupant or user of wch 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. ff the properly owner requests maintenance service o�repai�s be performed by the City,the property owner sfiafl be charged for the costs of the maiMenance and/or repairs,including necessary street repairs at a rate set annually by an administrative poliry. It shall be the responsibility of the applicaM, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the mai�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 remaios above the finished grade of the land or property. (Ref 638,1156,1191) Request for Service Repart � �it�r of Fridley R eference N o: 601-11-3263 D ate: 08101!11 Requesk Type= Install AMR meter Enkered By: Wendy Hiatt Department: Water Citizen tJame: Gary Walen Address= 540 53 1I2 AVE NE Callback Phane: 763-572-903Q Scheduled Date= 08104J71 10:00 AM�J� Property Owner: Location Details: Request Details= Change old meter Action Taken: i ` � Z _ � �1 �-� � � � � s . � n��c � � - t � ���� ' l r r� �C� -�G�.� � � C `� � Responsible Person: Approver. Completion Date: �� � � Citizen Notified E