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Meter Swap . Request Number: 14102 Public works Division Service Request Problem Address: 1647 Gar�na A�ne Requested By: Beverly Dahl Department: WA1ER Addresa: No addreas provided Problem/Issue: INSTALL AMR METER Phone Nnmber: 612-532-3503 Scheduted Dat • 2017-03-21 5c�edaled 11me: 07:OO:Of1 p � ST �1 ACl'ION NEEDED: Created by: We�iy Hiatt Date Cre�ed: 2017-03-1 S ACIION TAi�l�t: � ._....�._.._ _.._.___..._._.._._ . _ _. ..._ ��t�: ��o�ss Snbmitter H�s Been r, Contuted Dnte Completed: Completed by: �-�� 5�-57�-3�5� ��v� laere6�aut(�o�eze ttae� n#�rid! r�egclace�he vera�er�rae�er. �a�aaderstanc3 td�a��he ro e � e+f aredj�r its empdoyees to c10�nr�at ss nece� �, P � �ownes is�iaisle fos�fi#oe�rater lin�$rom the maie�to�3ae premise and�11 imerio �staasradsing. (8�er�ti y�8e��.�6� �ads�daoic8 the i".aty+�f�s�dley aa�d/'rts errogal�qees hasmless for any�lamages tisat naay�cctrr xrfiiie�loir � n�ea�asiora. �'4ais�o�ncltecEe,4au$saca�c diaa�stee!�o sralves,�lpin�aratls,fl�ers or�ae�rb stags&a�ox arad seavdce line_ Ira�nd�rstand i am also t�a8ataira a perax�i��ar"sos�o�aray ivnr�,i�F aaecessary. � 1 C,% .� �.-7(�;Z�7C�-C�� /-� S� � �� I �RtA��IETER a�EAo1�iG�ald mefier$ � . ��V �taane• � �Ic{dress `� �c��/ /�h�� P�one�tumber_ (n��—✓ 2J Z�,��67J �e �J`��J( ��` W.rrness Signattare �� l 7� o��t�G C��'��`o �� -- � � NEIi ' 49062829 ��r� IIIIII IIII IIII IIIII III E � 1 1 7'I 800596 �9�i4�LEY�1'6'K Ct�L)E Ct3A�'�t��02.YVA'fEt�,�'OR81P!W�,,71E4$�lf�iD�aK1YRARY SEWER q ADM191PAS�'RATi� �Tt��G`o�131°'�Y"#y.JV.7��g V67��9y�6Gy�y�9Qy��T • s'6��iq . ♦ 402.5 PER1Uf97"FEE Prior to constr�cting or�epair of ar�y water of sewer iirae connectir�g fihe e�cisting anunicipat system and any house vr 6uTdirig for rvhid��e applicatior�is made,fifre oavner or cors�tractor shatl be reyuired to obfiain a permit foc scrch connection,ancl staall pay a permit fee as prqvid� Cha�rCer 3��of�his Code. After such conr�ection has been made,the MH'ater and Sewec Departmerrt shall�e notified. tt shatl be ur�(aa�fui to any coxa�ecfiing(ine urrCil an inspection has been anade and�uch connection and the wor�c inaderrt therefio has L�en approved by the City a proper and suitabte cannQc�iora. 4t72A5 REPAIRS AiND�fAt�iTEA►qs1iCE T�COMNECI70N After the�niCiat connection fias been made�n the s�water service curb stop bosr or t�e semrer iead at fihe property li�or a water senrice lead f�een exfiended to the prcrperty line foc s:onr�edion,tfie appiicarrt,oevner,or occupartt or uset vf such premi�s SfraU be�at�ie for a11 repairs reqeairer�ta any aera#er line and sewer lines necessary#or connection of the premises from the main to the premises. lf the properfy o�r�er �equests rnairrxenance service or repairs be performed by tfse C'rty,the proper�awner shatl he charged for the�n#the mairrtenance an repairs,inctudirag necessary�reet repairs at a rate set annua�fy by an adnninistratiwe pv(icy, ft shai!be i�e+�esponsbiY►tr af the appiicacrt, owner,occuparrt or user to perform standard mairzteriance of fihe seurer service line fram the premises to the main aricludirtg debris dearing root tz��tCing and to mairrtain#he water service curb sCn�box for opera&ility anc�afi such#�eight as mrili ensure Chat it remains aboue Yhe finisP gracie of the land or prvperty. (Ref 638,1156,11R1j F �y s�R"� 3 �'iJ 'ik ^� c�i�'+R�� { .2. i � rid`4}^rs Name ��,c�'SS P � L✓�✓t�'� �� ` �. Date 1�r-��c> / Old Meter Number �� Old Meter Reading U � � Replacement No. �' �'S �7 6 Replacement Reading � Replacement Make��^ Remarks: ,j,;�, /�� "1�'�� S igned �'''✓_ _