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Meter Swap � , � � ' Request Number: 17245 Public Works Divjsion G, � t , _' �GQ ��u� � � j/y1�� r Servtce Reqnest �� Problem Address: b341 6S � �3K3 xeqn�:tea By: Ron Degartmeat: W Address: No Addrass providad ProMem/�ssue: STAL,L AMIt METER Phoee N�inr: 651-270-72d9 Scl�edW Ds�e: 201�� hedaled'nme: 01:00:00 rY� a�cnox�nEn: i u2^� Gz r�c�( � �` �j�t l� �r d Crtrtcd by: Wandy His�t Ihte Cts�ted: 2017-11-04 AC110N TAKF.N: _ ._.........___�__._ ___�_�. _.�._...�...._.....______��_.�_.___�.� � � � d Statu�: In Progress Snbmitter Has Been �..., Cont�te� �';�'� , Date Campleteds Co�leted by: ',�; r` ,,�, � \ , , 5��-- �� .� City of Fridley Water Department 6431 University Avenue NE �`.a�f7��1 Fridley,MN 55432 � 763-572-3566 �/We hereby authorize the Ctty of Fridley and/or�ts employees to do what is necessary to reptace the water meter. 1 understand that the properiy owner is liabte for the water li�e from the main to the premise and ail interior plumbing. (Per Ctty code 402.06) 1 also hold the City of Fridley andjits employees harmless for any damages that enay oca�r while doir�g this operation. This to inciude,but not limited to valves,piping,walls,floors or the curb stop box and service line. In understand I am also required to obtain a permit prior to any work,if necessary. FINAL METER READING(old meter) Name: Address /„{Lr�-/,� 1�N-M� t0�/ Phone Number Date � �—a-�''�] Sigrtature Witness Signature OLD METER# �(�.�r1�3.3�� SIZE & STYLE(Circlel OLD READING g t� �� 5/8" HEX NEW METER# �f�`t�l�� l� 1" NEW READING � 1�" ELIPTICAL or HEX ERT# �� rv� �,� 2„ EUPTICAL or HEX FRIDLEY CITY CODE CHAPTER 402.WATER,STORM WATER ANO SANITARY SEWER ADMINISTRATION (Ref Ord No 113,464,565,566,629,638,662,922,988,1144,1156,1191) 402.5 PERMIT FEE Prior to constructing o�repair of any water aE sewer line wnnecting the existing municipal system and a�y house or buiWing for wfiich the application is made,the owner or co�rtractor shail be required to obtain a permit for such connection,and shail pay a pe'mit tee as provided in Chapter 11 of this Code. After such connection has been made,the Water and Sewer Department shali be notifted. It shall be unlawful to wver any connecting line until an inspedion has been made and wch connection and the work incident thereto has been approved by the Cit.y as a proper and witable connection. 402.06 REPAIRS AND MAINTENANCE TO COtVNECTION After the initial connection has been made to the water service curb stop box or the sewer lead at the property line or a wate�service lead has been extended to tfie property line fior connedion.the applicant,owner,or occupant or user of such premises shalf be IiaWe for all repairs required to any water line and sewer lines necessary for connection of the premises from the main to the premises. If the property owner requests maintenance service or repairs be performed by the City,the property owner shali be charged for the cflsts of the mairitenance and/or repairs,including necessary street repairs at a rate set annualiy by an administrative poliry. It shall be the�esponsibility of the applicant, owner,occupant or user to perform standard maintenance of the sewer service line from the premises to the main including debris clearing or root cutting and to mairrtain the water service curb stop box for operability and at such height as will ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) . � �, �� City of Fridiey s� Water Department 6431 University Avenue NE Fridley,MN 55432 �;(��'��30�Oa- 763-572-3566 �lWe hereby authorize the City of Fridley and/or its empioyees to do what is necessary to repiace the water meter. !understand tfiat the property owner is liable for the water line from the main to the premise and aN interior pfumbing. (Per�ty code 402.06) t also hold the City of Fridley andrts employees harmless for any damages that may oca�r whtle cbing this operation. This to include,but not limited to valves,piping,walls,floors o�the wrb stop box and service line. In understand 1 am also required to obtain a permit prior to any worlc,if necessary. FINAL METER READING(old meter) Name• Address � �� Phone Number Date 11��'v� "1�7 Signature Witness Signature OLD METER# �3 ��3 �3 s�zE & STYLE(Circiel OLD READING S7 7,3 �t�� 5/8" HEX NEW METER# �� 'i �t�� ' ) � C`� IVEW READING � 1�4" ELIPTICAL or HEX ERT# 7 a c�y � 7 5s 2" �`�`�-- r HEX CHAPTER 4 -- �� ._ �,J JER l�'`{�" � (Ref Ord No 113,4 � , r ��ti� ,��'0�' 56,1191) %' 402.5 PERMIT FEE � t� Prior to constructing or repair of any water of sewe � � puse or building for which the application is made,the owner or contrador shall h �� Q�� O �II pay a permit fee as provided in Chapter il of this Code. After such connection has� '��ed. It shall be unlawful to cover any connecting line until an inspedion has been maa �been approved by the City as a proper and suitable connection. 402.06 REPAIRS AND MAINTENANCE TO CONNECI'10� After the initial connection fias been made to the wat� line or a water service lead has been extended to the property line for connection,tfie hall be liable for all repairs required to any water line and sewer lines aecessary fa __Jes. If the property owner requests maintenance service or repairs be performed� _�„ar�ed�for the costs of the maintenance and/or repairs,including necessary street repairs at a rate set a� _...�de poliry. It shall be the responsibility of the applipnt, owner,occupant or user to perform standard maintenan,�vrtF�e'sewer service fine from the premises to the main including debNs ciearing or root cutting and to maintain the water service curb stop box for operability and at such height as wiN ensure that it remains above the finished grade of the land or property. (Ref 638,1156,1191) .�