Meter Swap �
` Request Number: 13304
Public Works�ivision
Service Req�st
Problem Address: 1217 Hathaway Ln Requested By: Norma Horiedt-lacono
Departme�: WATER Address: 1217 H,�havvay In
Fridley,MN 55432
ProMemllasue � INSTALL AMR METER Phone Number: 763-180-6016
ScAeduled Datc: 2017-Q2-23 Schednled TSme: 09:00:00 m�`
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AG"TION NEEDED:
` Cres�ted by: Beth Kondrick DAte Created: 2017-02-06
ACTION TAKEN:
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Status: In Progress Submitter Hu Becn �,
Cont�cted
Date Completcd: �...a.,3--1� Completed by: � ��
Hoars �
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�43�.tln6versity�4venue nl� � \
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'* T53-572-3566 �
���e hereby authori2e#he�iiy of Fa�idJey and/or±ts emptoyees to slo what is necessan/ta
repiace the water�neter. i�nclerstand ti�at�he propee�ky oarner is iiabie for the water i'sne from the main to the premise and ali snfierior
p{urrabing. (Per Crty coste 4�2.06� i aiso hotd the Cit}i�f Fcidfey and/'rts em�sioyees harmless#or any�damages that may�ccur white doing thts
operation. This#0 9nclude,but not Cimited io valves,piping,wat{s,€loors or the curh stop box and service iine. ln a�nderstand d am also a�equi�
to otstain a permifi privr to any�vor�,if�ecessary.
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FHtHAL METER READING{olct meter} �� � ��
Name: ��(�i`/10�. '�"'�,�l�C�" ���d�__ V�M� �'�''�;f�l,.�'�''�,v�/ � •
Phone Number l��— / v� `tJi��� pate �, "��� � i� ,f
Signature _ WTrmess S�nature
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O�D READtiNG-_� � I ���
Af EW METER# � L� i V / tY tJ {
NEW READING �
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�RDDLEY CIT�f CtiDE
CH,�IPTER 402.WATER,STORM WATER AND SANtTARY 5E1NER
ADMIMlSfRATiON
(Ref Ord Na 113,464,565,566,624,638,662,922,988,1144,115G,i191)
402.5 PERMtT FEE
Pr�or to construcCing or repair aE any water of sewer t�ne connecting the existing munidpa(spstem and arry house o�buiiding for which the
apptication is made,the owner ar cor�firaractor sha(t be required to abtain a perm'rt for such connection,and shaU pay a permit fee as providezi;p
Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be noCi#ied. k shalt be un[au�ful to cm�
any connecting(ine until an snspection has been made acu!such connection artd the wos{c inaderrt thereto has been approved by the City as a
praper and suitabte connec#ion.
402A6 REPAiRS AND MAtP1TENANCE TO CONNECTlON
After the initiat conaeccion has been made to#he water servFce ourb stog bvx or the sewer lead at the pruperty line or a water serake lead has
been exfiended to the property li�e for cannection,the applicant,owner,or occupant or user af such premises si�a[!be liabie f�ail repairs
required to any water iine and sewer lines necessary for cflnnection af the premises frvm the main to the prem'�ses. tf the praperty o�mer
reyuests maicrtenance se►vice or repa�rs be performed by the C'�ty,the property owner shall be charged for the costs of the mai�enance andioi
repairs,inciuding necessary street repairs at a rate set annuaity by an administrative policy. it shati he the responsbility of the appiicari#,
owner,occuparrt or user to perform scandard mairrtenance of the sewer service(ine from the premises to the main induding debris dearing or
root cutting and to mairrtain ihe water service curb stop box for operabilyty and at such height as wiii ensure thaC it remains above the finished
grade af xhe land or property. �Ref 638,1156,1191)
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Old Meter Number
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Remarks: '��bQPt� f 1�,�1�
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