Meter Swap , Request Number: 13517
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PU�1C WO�3 DiVIS10D
Service Request
Problem Address: 1048 Hacbnann Circle Requested Bye Rayn�elle Delw
Department: WA'IER ,��eas; 1048 Hacl�Circle
Fridley,MN 55433
ProMem/sssne: INSTAI,L AMR ME1ER P6one Namber: 612-750-1760
Sched�iledDate: 017-0 1 Sched 11m�: 08:Otl:W
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ACITON NEEDED:
Created by: Beth Ko�rick Date Cre�ed: 2017-02-16
ACIiON TAKEN:
Sts�tus: In Progress ���er Hu Beea r,
Co�ted
Dnte Completed: Completed by:
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�43�.+�s�ev�rsity e�v��aue 4►1�
�raelle�g N6�i 5�432
753-572-3555
� 9'1A°� hereby autt�orize the�Cit��F Feidley and(or its ernpioyees to c!o what is necessary 4
�epface#he water meter. f r�nderstand that�he property owner is liabie for the serater line from the main to the premise and aIl inter'sor
� pturrtbing. (Per C'sty code 4A2,06� i also hold the C'rty af Fridiey and/"rFs em{�loyees harmless#or any�lamages that may occur rrhile doing thi
o�Oer�ion. This to 9nclude,bu�not 8imi#.�d to valves,piping,walis,flanors or�he curb stoP box arsd service line. In understand 1 am also requ
to obtain a permit pr'sor to any rror4c,�f necessaey. r t� t S.�� ��y� _ o�
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Fi�tAL bbtETER itEADHdG(old mefier) � � ! ,� �
!►tame:_,� �(� �Q,�VO pddress L'��� �d{„�w�.w �Y'
Phon�Number �1 Z"7�U"l 7(o O p� �v( (' ��
Signature Witness Signature �
OtD METER# CL/ C �C � l � J
OLD RfADtiVG � � � � ��
i1f EtN ME'a""ER#; .
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48906949
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11 7'1816794
FRIDLEY CITY CODE
CH�►PT'ER 402.WATER,STORM WATER AND SANITARY SEWER
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�Ref Ord No 113,4G4,565,566,629,638,662,922,9$8,i144,i156,T191)
402.5 FERM17 FEE
Prior to constructing or repair of arry water aF sewer line connecting fihe existing maniapal system and arry house or twtldfng fo�wf�ich#he
appl4catifln is enade,fihe owner or cor�tractor shatl be required fio abtain a permit for such connection,and shall pay a permii fee as provided i�
Chapter 11 of this Code. After such connecCion has toeen rnade,the Water and Sewer Departmertt shal!be not�fied. �t sha(1 be un(awful to coa
any connecting[ine uMi!an inspection has been made and such connection and the wor�c inaderrt thereto has been approvsd by the CYIy as a
proper and sui�table connecCion.
402.OG REPAlRS AND MAINTEfyq�ly�CE TO CONfyER10N
After the initial connection has been made to the water service curb stop bou or the sewes lead at the property line or a rrater senrice tead has
been exfiended#o the property)ine for connection,the appiicarrt,owner,or occuparrt or user af such premises shali be iial�ie for aN repairs
required to any water I�ne and sewer lines necessary for connection of the premFses from the main ta the premises. if the p�^oper�y owr�er
reques#s mairrtenance service or repairs be performed by the City,the property vwner shali be char�ed for the costs of the maintenancQ andJo
repairs,inctuding n�cessary sireet repairs at a rdte set annuatty by an administraitive poPry. It shafl be fihe responsbitity of the appiicar�t,
orvner,occuparrt vr user to perform standard main#enance of the se�urer service line from the premises to the main including debris dearing or
root catting and to maintain#he water service curb sfiop box for operability and at such heighY as arill ensure Chat it remains above#he flnished
grade af the land or proqerty. �(te{638,1156,1191)
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Citp of Fridley
Wat�r De,partment
Address b�V-"`",� ��-MA� 4�►
Name ��G� S�-P�
Date �� �;� "(��
o�c1 Meter xun�er fl 1�
,
Old Meter Reading � �
R�placement No. !� �
Replacement Reading�
Replacement Make ��C-x�"�
Remarks z ��C�'I i�2�� �
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