Meter Swap �
� Request Number: 13594
Public works Division
Service Request
Problem Addresa: 1060 Hathaway Ln Requested By: Becky K
Depxrtmeat: WA1ER Address: 1060 Hathavuay Ln
Fridley,MN 55432
Problem/Issue: INSTAL.L AMR METER Fhone Nnmber: 715-897-2185
Scheduled 2017-02- � Sclt�dnted 1lme: 01:00:00
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Create�by: Beth Kon�ick Date Cre�ed: 2017-02-21
ACIION T�€EN:
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Statas: In Progress Submitter H,ra Becn r
Co�acted
Date Completed: Completed by:
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Fs'adle�o M�61� r�432 �i�j I
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� '/'A°� hereby autf�orize'#he�i�ty�f Frrdley andJor its employees to sto what is necessary 4
�eplace the water rneter. 1 vnderstand i�hat the q�ropesty owner is liabie for the arater Pine from tt+e main to tFee premise and a117rrcerior
plurraBsing. �Per City sode 402.06� !also itotd ihe C'cty orE Fs�idfey and/'rts em�xioyees harmless for eny�lamages that may occur while sloing thi
oper,ation. This to�nclude,bug nox lians#ed to valves,piping,waf(s,t400rs or the curb stop k�ox and servece line. In anderstand 1 am also requ
ta obtain a permrt{oriar#o any�ror9c,if�tecessary. �
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FIPtAL METEl2 READIt�iG(aict meterp � � � � � 1 � �J
Name• ���" � Address �+ �
Phone Number�(��,�� �p�Z"��+' ��
$I�fla'tU!'2 1�(�'G'12SS Sigl'liiCl/I�P
o�.D���R�_ �� � � �,� ��
OLD READtNG �� � � '� ��
NEW MfTER#�-Y�� �1P I lA
NEW READiNG t J
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FRIDLEY CfTY CODE
CHAP3'ER 402,WA7ER,STORM WATER AtYD SANITARY SEWER
ADMt'N4STRAT60N
(Ref Ord No Z13,Q54,565,�6b,629,638,�i62,922,988,I144,II56,1191j
402.5 PERiIAi'i FEE
Priar to constructing or repair of any water of sewec rne conaect�ng fihe exisfing municipal system and arry house or buiiding for w6ich the
application is made,the owner or contractor shatt be required to obtain a permifi for such cannection,and shail pay a permi�t fee as provided ii
Chapter 12 of this Code. After such cannection has been made,the Water and Sewer Departnertt shall be notified. ft sha(I be uniawfu(to cflv
aray connecting tine ur�tii an inspectSon has been made and such connection and the worh inaderrt thereto has�een appcovQd py the C-y�y as a
proper and suitable canneckion.
402.06 REPAIRS ARIp yl►Tq�N-I'EfYppICE TQ CONfYECT10N
A#Cer the initial connecfiion has b�en made to#he avater service wrb stop box or the sewer lead at the property iine or a wa#er sendce lead fias
bee�exfiended to the property iine for cannedaan,the appiiprit,owner,or accupani or user of suth premises shatl be Ifahle for ali�epairs
required to any water line and sewer lines necessary#or connettion of the premises from the main to the premises. If the propesty oarner
requests maintenance service or repairs be perFormed by the City,the property owner shall be charged for the sos#s of the maimenance andJa
repairs,includirag necessary sfireet repairs at a rate set annually by an administrative pol�cy. It sfraif be ti�e responsibifity aF the appiicarrt,
owner,occuparit or user to perform standard mairntenance of the sewer senrice line#rom the premises to the main including debris deartng or
root cutting and to maintain the water service curh stag box for�perabslity and at such height as witl ensure thaC it remains above the#Pnist�ed
grade of#he land or property. (Ref 638,1156,1191j
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�t��er De��c� ' ex�.'t
Address � �(J (� V i,a7'hQ� �
Name 1�' °�(,�,' l�`G
Date � � �`j "V�
Old Meter Number � J � �:�
Old Meter Reading � � � �
Replaeement No. � ��� � 7� t�_ ___ _
Replacement Reading�
Replacement 1+'Iake �r
Remarks: ,,��� ���"r
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S igned, ���i`�