Meter Swap 1
Request Number: 13514
Public works Division
Service Request
ProMem Address: 5562 Fillmore St Requested By: Amin Borji
Department: WA1ER Addresa: No address provided
:problem/Issue: INSTAL.L AMR METER Phone Numb�er: 1-630-518-8950
5chedWed Dat • 2017-02-27 Schedaled 11me: 07:30:Q0
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ACTION NEEDED: ,,.;�,t
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�'"'�" Crcated by: Wendy Hiatt Date CreAted: 2017-02-16 ;
ACIiON T.4t�N•
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Status: In Progress 5abmitter Has Beee r
Coutacted
Date Compietedc�_ � v Completad by: �
Hoars � � � �Gl.�
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5433.t9niversity Ave�ue 9N�
Fridley,N!N 554�2
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.� T53-572-3566 �� �,_ ���s � � � —��
� �/�e hereby authorize the�iiy of Fridley andjor its empioyees to do what is necessary to
replace#he water meter. 1 understand that the property owner is liabte for the water line#eom 2he main to the premise and a!1 interior
plurrebing. (Per City coale 402.06� i aiso hold the C'rty of Fridley and/'rts empioyees harmless#or any�lamages tfiat may�uur while doing this
oper,ation. This to include,but not Iim�Yed io valves,piping,vieaqs,#loors or the curb stop box ancf service line. In understand 1 am also requir
to obtain a permit prio�r to arry�ror�c,if necessary. �
FIWAL METER READING�okt meter) l �a�7 �� a
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�ame: DI/1
` Address_�J�`'r� �� ul� '�'�O� ST i
Phone Number _�`�'�v" � "�g�V Date �" � l�`� ��
Signature NliO�ess S�natisre �—
o�D M��R#�C�B ��f ��7
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OLD READiNG_ �' i � 7 L L �
NEW METER# �� O�0� 1
NfW READif11G V
�RT# `� l � �� 55 .
FRlDCEY CiTY CODE
CHAPTER 402.WATER,STORM WATER AND SANITAttY SEWER
ADMlMISTRATION
{Ref Orsl No 113,4�64,565,56b,624,638,662,92Z,988,1144,1i56,1I91)
402.5 PEit11A1T FEE
Prior to constructing or repair of any water of sewer line connecting the eRisfing muniapal system and arry house crr buitdir�for which the
application is made,the owner or corrtractor shatl be required to obtain a permit for such connection,and sFaall pay a permii fee as provided in•
Chatrter 11 af this Code. After such connection has been made,the Water and Sewer Departmerrt shall be nofified. tt shalt be untawfui to cove
any connecting line urtitil an ir�spection has been made and such connection and the wor8c inaderrt thereto has been approved by the C'rty as a
proper and suitable connection.
402.06 REPAlRS AND f4tA1NTE(MANCE TO CUAINECTION
After the initiel connectiort has been made to the water service curb stop box or the sewer lead at the propecty iine or a waLer service lead has
been extended to the property line for connection,the appiic�rrt,owner,or accupant or user of such premises sfraii be iiable for ail repairs
required to arry water line and sewer li�es necessary for connection of the premises from the main to the premises. tf the propeny owner
requests maiotenance senrice or repairs be perFormed by the C'ily,the property rnvner shall be charged for the cosfis aE ihe mairrtenance and/or
repairs,induding necessary street repairs at a rate set annualty by an administrative poliry. It sbap be the responsiNitity o#the applicarrt,
owner,occuparrt or user to perform standard mairrtenance of tfie sewer senrice line fram the premises to the main induding debris dearing or
root cutCing and to mairrtain the water service cur6 stop box for operability and at such height as wili ensure that it remairis above the finished
grade af the fand or property. �Ref 638,1156,1191j