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Meter Swap �, ti Request Number: 16251 Public Works Division Service Request Problem Address: 730 67th Ave Requested By: David Phillips Department: WA'IER Address: No address provided Problem/Issue: INSTALL AMR METER Phone Number: 612-382-6279 Scheduled te: 017-07-07 Scheduled 11me: 09:00:00 �� .� ACTION NEEDED: Created by: Wendy Hiatt Date Created: 2017-07-06 AC'ITON T N: ^ __�� ...._ti__......_.._..____..�................_.�_____._............�1�........__._..____..__._..._._ __._..__ __.__._._._.�________. �. Status: In Progress 5ubmitter Has Been r Contacted Date Completed: Completed by: _la � � I1 .��--� 1� 2� - �� l� •-��. �' �U �- ��l tG + City of Fridley Water Department 6431 University Avenue NE Fridley,MN 55432 763-572-3566 �/N+e 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 line from the main to the premise and all interior plumbing. (Per C'ity code 402.06) i also hold the City of Fridley and/its employees harmless for any damages that may occur 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 I am aiso required to obtain a permit prior to any work,if necessary. FINAL METER READING(oid meter) V v� ` v� Name• [�N��i�V� �� Address � JlJ �� --r-- Phone Number.�f�V V� �� Z��e `'—�" �� Sig,�ature Witness Signature OLD METER# �� c� �� OI.D RfADItVG_ � J�� Jl./ NEW METER# �� NEW READING ERT# � �� — 1 FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER AND SANITARY SEWER ADMtNtSTRAi'tON (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constrocting or repair of any water of sewer line connecting the existing municipal system and anr house or buiiding fo�which the appiication is made,the owner or contractor shali be required to obtain a permit for such wnnection,and shall pay a permit fee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Departme►it 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 initial connection has been made to the water service curb stop box or the sewer lead at the property line or a water servi�e(ead has been extended to the property line for rnnnectfon,the applicant,owner,or occupant or user of wch premises shal!be liabie for aU 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 mairttenance service or repairs be performed by the C"rty,the property owner shalt be charged for the costs of the mair�tenance and/or repairs,including necessary street repairs at a rate set annuaily by an administrative poliry. It shall be the responsibility of tfie applicaM, owner,occupant or user to perForm standard maintenance of the sewer service line from the premises to the main inctu�ng debris dearing or root cutting and to maintain the water service curb stop box for operabil'ity and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) , - ��o� � ��i� City of Fridley Water Denartment Address � �j � I'�� - Name �Av�d P ;��i� Date 6�' g�� Old Meter Number 3 {�-S Old Meter Reading �� ! �� Replacement No. � �j � y Sb � Replacement Reading Replacement Make l� 0.� �Q../"" Remarks: j I�a.�Cy rn� Signe .� < i :f ,•