Meter Swap � Request Number: 13780
� Public Works Division
Service Request
Problem Addreas: 1340 64th Are Requested By: Sharon Ramscy
De�rtment: WATER Addresa: No ad�ess provided
Problem/Issue: INSTALL AMR METER P�oae Nnmber: 574-9322
ScLeduled Date: 2017-03-09 Sc�doled 11ek: 10:30:00
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ACTiON NEEDED:
Created by:. Werniy Hiatt Date Cre�ted: 2017-03-02
ACIION TAitEN:
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Date Com�eted: Completed by:
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9��a� i�es'eny auCf,oriz���ae�' o#�e�edl
�egal�ce�e�rater�aeter. ��zasderstanr!t�a��he ro e � ery andjoe-its eastployees#o do�vhat ds r�ec.e.ss
€� P �Y owner�s�iakale foa�fif�e�rater 4ie�e�rom tt+e anaie�fio�ae premise and all imer'soi
�Staareaisirzg. �Per�C"rry sade�Z.QS� i aiso�ea9d the�'st�j trf�sidleyr and�Sts em�slszyees harmless for am��ama�es't�eat seaay�ccur�rhite�oir:
-�, a�aer�tion_ T9ais�o�ncfucEe,�au�no�dSaa�stecl�o wahres,piping,mratls,#loors�r�ae zcarh stog taox aesd seruice�ia�e. fra understand i am also
• t�m o�taira a pe�nit�araos to�eay�rnr�,��ecessas�e�.
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Stgrtature '�. __._
fAl�tness Si�r�ature_ �l\
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c[�A�'�'��IZ.�U'ATElt,STQR�!W�4.�E4�AND SANITARg SEWER
ADM11�6STRA7'9C�Di�f
�R�Ord 8�[0�.130`l'i7Yy�V.Dy�6�p Vd.7)57+7Up V���9L.+Gy 7410q.1���1 s ���.Ai71�
�Q2.5 PERRfT9T FEE
Prior to constructing or repair af arry water aF sewer I�+ae connecting tt3e existing arruniapat system and any fiouse or fxriid"mg for which the
aRArcafiifln is rnade,ttae o�vner or corrtractnr shall be required to olrtain a permi�for suda connectiory a»d shall pay a permit fee as provide
Cha�oter 3.�of this Code. qfter such conaection has d�eer+rnade,the�Ilater and Server Departmerrt shali ite noi3fied. �#sha{!be uataarfu�#n
aray connecting Sisse un�ti{an inspection Y�as been made and�uch connection and�fie vwortc inr.iderrt thereto has t�een aPProved bY the City a
pmper and s,ui�tab�e connectia�a.
MJZA6 REFAlRS�RI�D 9UtARVTENApYCE TO COfW�iECl'ftlfOf
A�Fter the inr'rial cortnectian has been made�o the wa�teer service curb sto�boec or the se�arer iead at�r3se Pmperty'fine as a water service iead
been exfienti�eti to the pro�+e,'tY line for connection,tf�e appiicarrt,vwner,or accu�arrt ar usec of such premises sha(i be iiat�le for afl re�irs
require�d to arn�water line and sewsr 1'snes s�ecessary�ar connection of�tiie�remises fro�sr the main to the premises. tf fihe properry ormer
reques�s mairrtenance service ar repairs be perFormed bp the CitY,the property awner sha{1 be d�ar�ed for�ehe�casEs u�#he mairn�nance an�
repairs,iradudirag necessary street repairs at a rate set annua�ty by an adnnin�ive pot'�cy. �t sfia!!be ifie resporis�it"ity*of the appGcarrt,
4wner,occupant�r use��to per�orsn standard maimena�ce of the sewer seraiice line from fihe premises io fihe main�ndud�rig debris dearing
�'oot�u�tting and ta mairrtain the water service curb stop box for operahility and at su+ch fieight as rwn'll ensure that it remains above the finish
grade of the land or p�operty, �l�ef 638,1155,1191�