Meter Swap � Request Number: 13791
, Public works Division
Service Request
Problem Address: 5925 Haclunaon A�e Requested By: J�t Balej
Depirtmeet: WATER Addres:: No addres�provided
Problem/Ias�: INSTALL AMR METER �hone N�ber: 763-898-0325
Scheduled Dat : 2017- 3-09 � Sc�edele�'Rme: 08:30:00
I U !�
AC'IION NEEDEU:
CreAted by: Beth Koncirick Drte Created: 2017-03-02
AC7ION TAI�:N:
��S-�,l I ���'
�,
Statva: In Progress ��ner Hau Been �.
Co�acted
Date Completed: Com�eted by:
�� �vt� �
`� r
��.3-s72-3���
3��w� Iaes^�6y autho�ize the�' �#�r�d!
rego9ace tS�e a�ra�er metec. ��a�aclerstanc!ii�aa�the ro e � �arad/or its ern�a7oy�es Lo�to xr��fi is nece�s
laarrabin P P �'ownes�3ia�le fmr�lae vvafier 9ie�e from the�naias to�ss premise and aii imer7oz
A g• �8'ea��C"�ty socle 4�2.�� 3 ad.s��eoid the�'rt�,+�f��idley aad�afis em�mlrayees 4saam(ess for ariy�amages tEe'at aaaay occus�+faiie rtoir:
v�aea�a�tion_ �'4�ais ta��luc8e,�arat reo�3aaa��LYert�o walves,qaipin��eealis,fdsaers�r t�ae saar9a stop box anc#servece�ine. Ira und�rstand�am alsa
� fi�o o�t2ira a
�Sera�nit gar�ar to aaay�ror�C,�F�secessare�_
' 21 � - y.`�� 11 Q - �2
���n��z r��n���o �,ere�-1
� '--� �� C� 3{� � .� 2� o--�
tl�ame: 1�'�/� , Axtdress �� C�S
PE�one 9tumises- V�� J �j� �' �' I�
Signatu� W�tness S�natexre
�LL��i6E'�"�!t�_ Y J�� � �p�
oL�,��t�G L ��� � 3 O
�����R� '��I�� ?�4���
��-��b
���-� � ��� t 2�� .
�ti��.�v�tnr�t�D�
�FIAI�'ER�QZ.YVAT�Eti,STO�!1{6(��''E�AN�SANi3ARY SEWER
AD9i�lINlS�'1ZA'f90i1P
(Ref Orsi 30[0 9.23,�46,565,�6b,629,638y�i62,922,988,11�4,1156,�191�
4Q2.� �EF�fi'�'FEE
Prior to consts�tscCing or repair aF at�y water of sewer li+ae connecting tFse existiesg rnuniapal systera and a»y nouse or bui(dirig for erhich the
appiicafiir�n is made,tfre owner or corrtractar shat[be required to ohtain a p+ermifi for such connection,and sf�all pay a perm'sT fee as prouide
�hapter�3 rrf this Cade_ qtte�s�acfi�o�orectinn i�as been made,the�Ilater and Sewer Depastmerit shalf�e reo�ified. it shail be uniawfuJ to
aray coranectang GnQ uMti�an i»spection i�as been anade ar�ci such s:onned3on and tfie wos�c inciderrt#he�eto has been aPP�d fiy the�}r a
proper and suitable con»ectiara.
40Z.06 REPRtRS�ND�,RAIAtTENANCE i'a CONNECTiON
AiFter the initiaf conrsecCivn f��been made to the wai�r servec�curb stop bv�c or�ee semier fead at fiFse pmp+ertr�line ar a waiter s�nrice�eacf
been exteraded to the prvperty line for conreedaaa,�e appi'�carrt,awner,or rrccuparrt ar user o#such prernises shal!be i'�abie far aN repairs
require�!to arr��►ater�ine and sewer iines necessary#or connection aF#he premises frvr+�tf�ee main to tise premises. if the property ormer
a�equests mai�es�ance service or repairs be perFormed 6y the C'ity,fi.�e pr+�periy orrner shall be�harged for fihe�of the mairttenance aru
repairs,iractudirag necessary stree�t repairs at a rate set annuaiiy�an administrative poticy. �t shat!be fihe r�spnnsi6it'�ty af the a�icarrt,
owner,occu�rarrt or user fio perfvrn�scandard anairrtenance aF i�e sewes senrice�ae from ihe pvernis�s#o�the rr�ain�ndudir�debris dearing
roo�t r.u�tCCing and fio mair�tain the water servir,.e,curb y�top bou fo�operataility and at such i�eight as wi11 ensure that it rernains above thQ finish
grade of the�and or�aro�eriy. �fFef 638,1156,1191�