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Meter Swap � Request Number: 14'776 Public works Division Service Request Problem Addr�as: 577 54th Ave Requested By: Michelle Fyle Deputment: WATER Address: No�ess provided ProMem/Iss�: INSTALL AMR ME1ER Pho�Nnmber: 612-298-3339 Sched�ed 2017-04-2 Sc6edaled 1lme: 07:00:00 � n/ ST m AC"IION NEEDED: Created by: Wendy Hiatt Date Created: 2017-04-19 ACPION T�KEN: �r�S�C�e� �--- Status: In Progress Snbmitter Has Been r, Coatncted Dxte Completed: �'� �,_�� Completed by �k� . 2�� v �- �� - 5� # �� City of Fridley Water Department 6431 University Avenue NE Fridiey, 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 ali trKerior plumbing. (Per City code 402.06) 1 also hold the City of Fridley and/its employees harmless for any damages that may ocwr while doing 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 any woric,if necessary. FINAL METER READING(old meter) ��`-' 4 V" Name: "�`u C��'`� �I li � �� Address J�� -t� � Phone Number `C. ��—' � 1 1/ � �� Date l � �� / Signature Witness Signature OLD METER#_ ��/'� � `� � OLD READING �o�-g V� -G� NEW METER# I (�D � �U 1 NEW READING V ERT# / 4`��V`�p�� , FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191j 402.5 PERMIT FEE Prior to constructing or repair of any water of sewer line connecting the existing municipal system and any house or building for which the application is made,the owner or contractor shaH be required to obtain a permit for such connectton,and shall pay a permft fee as provided in Chapter 11 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 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 initiai connectio�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 connection,the applicant,owner,or occupant or user of wch premises shall be liabk for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If ffie property owner requests maintenance service or repairs be performed by the City,the property owner shall be charged for the costs of the mairrtenance and/or repairs,including necessary street repairs at a rate set annually by an administrative policy. It shall be the responsibilily 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 cutting and to maintain the water service curb stop box for operabil'ity and at such heigf�t as witl ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) ��3 � �r[.F(�3�1 J �� t ✓ City of Fridley Water Det�artment Address �� y � Name n� �� . Date �� O Old Meter Number � �� Old Meter Reading � q � � Replacement No. �6 3 � ��b � — Replacement Reading � Replacement Make �G.�� w Remarks• "�� i°r"" S igned�� A � t. .� � F a' � p a-v��l ��S,,f i�--��yH� city of Fridley Water Denartment Address_ �� Tj� �-� �,�/ � y,� y r Name 1 I�C�E �t�Q �0.fTOr Date � - � J" � � Old Meter Number �� 9� �$ sQ Old Meter Reading �. � (� d Replacement No. �. � �Q v Replacement Readinq ' Replacement Make C� .��• Remarks: 5��•r , ` � Signe � 4 4 f �.