Meter Swap ,
s " Request Number: 13284
Public Works Division
Service Request
Problem Address: 1111 Lync�e Dr Requested By: Craig
Department: WA1ER Address: 1111 Lynde Dr
Fridley,MN SS432
Pro�eml�ss�: INSTAI,L AMR ME1ER Phone Nembers 609-824-0100
Schedul�ed Date: 2017-02-10 Sc6ed�led 1lme: 07:00:00
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ACTION NEEDED:
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Crc�ed by: Beth Kon�ick Date Created: 2017-02-06 �A
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ACTION?AI�N:
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�a��r � � �
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St�ns: In Progress �bmitter Au Beea �
CoHtscted
Dste Completed: ,?^ lU� �� Completed by: ��1. �
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6431.l9ndvQa�siiRj A�rera�ae N� �� •� 1 � �
��redtsy,61AN 55432
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7��-��z-35�6 � �� _ y �1 c y�- L� �
+ !,�"°� her�by authorize the City�f FrKiley andjor its emptoyees to slo what 9s necessary
' repiace#he water meter. 1 understand tha#the property owner as tiable for the aerater line#rom the main ta�tee premise and alt irrterior
plurrrbing. (Per City cosle 4tYL.06j i also hold the Ccty of Fcid(ey and/'rts empioyees harmless foe any slamages that may occur�rhile doing tF
operation. Thi�#o include,bufi no#Bim'rtec!to valves,piping watls,Floors or the curb sta�o box and service line. In�nderstand 1 am also req
to abtain a pers►irt prior#o a�y�ror4c,�f�e���y.
F1N1�1.METER READIAiG{ok{mefier) v ������
l�ame: `-" '^�c� Address � V l l �Y�� �r .
Phone Numbef�� l' �� [ `�C(.TQ Date � � t U � ��
�►�u� `
w'ra�ess signature
OLD 1WETER# ���� V� ` 1
OCD READtNG_v ` � 1�
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N��M�R� � � � � 78� �
NEW READI0IPG v
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FRIDLEY CIT'Y�ODE : "��
CHAPTER 402.WA'TER,STORM WATER AND SANITAliY SEWER
AD9tt1lNlSTRAI'901+ot
�6ief Ord No 113,464y 565,��6,629,638,662,922,9$8,i144,I1S5,1191j
4U2.5 pER11111T FEE
Prior to constcuctirtg or repair af arry water oF sewer iine wnnecting the euisting municipa!system and arry hause or buiiding for whid�tfie
application is made,the owner or corrtracta�shait be required to abtain a permit for such connection,and shal!�ay a permitf�e as�oyide+�
Chapter 12 of this Cade. After such connection has been made,fihe Water and Sewer Departme►�rt shal4 be nat'rF'ied. tt shail be uniawrfut to ca
any conn�cting line untii an inspection has been made and such connedion and the wo�c inaderrt thereto has been approvec►by the City as a
proper and suitabte connectian.
d02.06 REPAiRS pND MAfPITEA(q1YCE TO CtMtKECTtafY
After the initiat connection has been made to the water senrice cur}�stop box or ti�e sewer lead at the property iine of a water s�rvice�ead ha
been extended#o#he praperty fine for connedion,the applica�,owner,or cccuparrt oc user of such premises shaH be liabie f�ap repairs
required to arry water line and sewer lines necessary#or connectian of the premises from the main to the premises. ff tt�e���
requesfis mairrtenance service or repairs be performed by the C'rty,the property owner shail qe charged for tt►e costs of ihe maintenance and/
repairs,inctuding necessary street re}�airs at a rate set annuaity by an administraiave policy. 1t sf�ail be the responsbil'iiy of the appiicarit,
owner,ocsupant or user to perform standard mairrtenance of the sewer service line from the premises to the main�nciuding delxis dearing oi
root cutting and ta maintain the water service curb sfiop box for o�erability and at such height as wili ensure tfiat it remair�above the$n�shet
grede vFthe{and or property. (Ref 638,1156,1191�
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City of F=idley
Water Departm�
Address � 11` � 4R1� ���
Name utST
Date ►� ��'-0 �
Old Meter Number ���� �g��X----
,t�11�`� p�.
Old Meter Reading
Replacement No. � I
ReplacEment Reading
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Replacement Make �-
o�.� �,�f 1 ��
Remarks:
S igned (r��
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