Meter Swap .-,
� Request Number: 14092
Public works Division
Service Request
Problem Address: 1611 66th Ave Requested By: John Luhman
Departme�: WA1ER Address: No ad�esa provided
Probtem/Isaue: INSTAi,L AMRMETER P1ane Number: 763-571-8787
Scheduled Dxt ; 2017-03-22 � Schednled 11me: T0:30:00
� G�r ��' 30
ACIION NEEDED:
Created by: Beth Kondrick Date Created: 201�-03-14
ACIION TAKEN:
�__�___�`���� �� �
Status: In Pro ss Snbmitter Aaa Been �,
� Contuted
Date Complehd: Compieted by:
`�- - � �b►'�'
Z� �� �
�, ..
�;.F.
�s�-���-����
9���
here6y au�o�ize the L'r�gv�#�r"sdley ared/�r ats emp�oyees t:a�Yo�vi�a#ss neces;
rega9ace�he rera�er meter. �vaat8erstanci�iat�he pro�ea-tty owner�s dia�le fa�r tlae�rater liste�rom�he anais�to�ae premise ar�d all interio
� •� �Sfazraal�ing. �Per�e y�octe�t3�.�6j �ads��Co�d�e�'rty�f Fsedle�and�"rts�rn�t�ye�s hasrniess for ar�y�amages tiiat e�eaay�ccur w�a�le sloir
�pee�a^aion. �ais�o�nciucfe,iau$�acatt�eaa�a�ted to valves,��pfr�g.�rradis,fl+noe�s or s�ee�a.'r8a sto��ox�rad servcce lis�e. Ir¢�snclerstand�am also
tss o8a�taira a�Serrnit garao�r io�ar�y�ernr�,if�tecessarye
�2�� .� u 6�� � �c� �- � I
F9�tA��ETER�A�1NCa�ofd meter� a s o � � � D ` � �� �
�a��: �o�,v� ��w�l.u� �� �,l l �o�o�"` �--
Ptaone�tumi�er��� '�'� ` �—��? Date �'� L� `�
Signature Nti��s 5�gna�ure
o�� �����2�� ���70
o�D��t�� � �4 � `� I Q
����,�����°�C� ���g
���— o
���� -� a � � � �-� � .
��D�������
c�,����.�A�R,�����������������
�������
(i��CBrc[8Ho 9.138�&40�65,a6�,629,63�,�2,9�2,9$8,I144,1156,119�.�
4tiZ.5 PERM9i"FEE
Prior to cvnsi�cting or a�epair aF ar�y water oF sewer 3i+ae connecting the exastir�g rrrttnia�ai systerrr and arry�aouse o�fn.tTding fo�wf�ich#he
apptication is made,fihe oarner or corrtractor shatl be�equired t�obtain a g�ermi�for sur.t�cormection,and shali pay a permit fee as pro�id,
Cha�rCer 3.3 of this Code. After such connection has been rnade,the Water arad Sewer De{tartmertt sha11 tie qo�Cified. tt shatl be untawfui to
ar�y connecCang tine ur�tii an ins�oection has 6een anade and�uch connsction and the wor9r inciderrt thereto has i�een approved by the CFty a
proper and sui�tab�e connectiora.
402.Q6 �2EPAtti�s4ri{D�tA1NTEiVA9�iCE TCd COAtNECT1QN
AiF�er the tnitial connectian has been made�o the rora�er service curb stop bv�c or t�se setiver iead at t�se propertY iine or a water service lead
i�een e�ended to fit�se property line for conraectior�,ifie appiicant,ovrner,or oecu�arrt ar axser of such premises sha(i be iiabie for�►i repairs
require�!�to arty water dine and sewer lirtes necessary#or,cannection of i:he premises from#he main to the premises. if tf�e property owner
�equests mairrtenance service vr repairs be perFormed 6y*,he C'r�y,ttae propea�.y owner shall[�e charged fvr the�trf the rnaPrrtenance an
repairs,incfud�rag necessary street repairs at a rate set annualty b•,�an adnninistra�iue poticy. it sfiat!be tHe resp+ons�itity o#fihe applicarrt,
owner,vccupant or user to perform standard anairrtenance vF the seurer service line from the premises to the main aadudir�g debris dearing
rocxe cufiting ar�d to mairrtain the water serv�ce curb stop box for operabiiity anc3 at su�ch heaght as wPii ensure that it remains above the finist�
grac9e of�khe lancd or g�roperty. �Fieif 538,1156,1192)
,.. � ��� �j r�
���'��
� �
; City of Fridley
,., water Depa=tment
! � _ .
... Address ���� �� �Z J`h�.a-c-�.._ '.
.. ; --� � _._
Name��j. L �-� �a-+ o�,�,.- � _ _
, ' Date �� - `� � "�a __
' Old Meter Number � �"��'"� 0 3 J� '
' Old Meter Reading � � �� . _ _�. _.
. , Replacement No. 3 b � �� � � � _
`" ' Replacement Reading �' `
. .. . ,_ _ _
Replacement Make �t4, ;
... ' Remarks: S l �'�^��'�' ' _
Signed
,,. _ _ __ ¢_ _. r_ _ . _.