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Meter Swap , 'R. � Request Number: 13363 Public Works I)ivision Service Request Problem Addresa: 1001 Lynde Dr Requested By: Hala Hamade Departmeut: WATER Addrea:: 3 001 Lyrule Dr Fridley,MN 55432 Problemllsane: INSTALL AMR ME1ER Yhone N�ber: 612-249-6462 5che�nledDate: 2Q1?-02- ,� Sc6ednledllme: 07:30:00 (� . ACIION NEEDED: CreAted by: Beth Koudrick D�te Cre�ted: 2017-02-OS ACTIO TAI�N Sta�s: In Progress ��rter Has Heen r Contaeted Date Completed: Com eted by: �.- a- �1 �' ..�u�.�..r vs�,ecYe Y.IHA�CIILL �433.l7a�dversit�Av��a�ae iV� �� �� �� Fridley,M{V 55432 � 763-572-356� ���1_�.y �J 'l,j�--� � / • ' I � jj''"�� here6y authorize#he�rty af Fridley and/or its empioyees to do whafi ds necessary to � replace#he water meter. !understand tha#the ro e p p rCy owner�s liable for the water line from the main to the premese and all irneriar piurrabing. (Per Gty code dQ2.06j i also�ofd tfie Cit�o#Fridley and/its employees harmless#or any slamages that may occur wh+le doing tE�is operation. This�o include,but not limited�o valves,piping,walls,fDoors or the curh stop bux and service line, in anderstand 1 am also requir to obtain a permit prior to ar�y�ror4c,if a�ecessaey. FtMAL METER �qDtAfG(old meterj � `'� ��' �� Name: wR W` ��,�1" W�(�Q� Address Pbane NumberSG1 M lJ �-1�'�1r✓ 1 ace_ �''�*'r � Signature Witness Signature OLD METfR# � �j � ����� OLD RfADtNG �����j � V NEWMETER# �6J l.� ` �J V� � �� .�(� � g� v G(�� � r-- � NfW READI611G � �R�#_"� �� 1 ��3 � . FRIDLEY CITY CODE Ct#APTER 402.WATER,STORM WATER AtiWD SANITARY SEWER ADMINISTRATtON (Ref Ord No 113,464,565,565,629,538,6fi2,922,9$8,1144,i156t 1191) d02.S PERMIT FEE Prsor to constructing or repair of any�rate�af sewer line connecting the existing municipal system and arry fiouse oc buiiding for which the epplicafiion is made,the owner or corrtractor sha(I be required to abtain a permit for suct�connection,and shail pay a permit fee as prpvided irr Chapter 11 of th�s Code. After such cannection has been made,the Water and Sewer Departmerrt shaii be notified. it shall be u�tawfui to tove any connecting line ur�tif an inspection has been made and such connection and the wo�inaderrt thereto has been approved by the City as a proper and suitable connection. 4Q2.06 REPAiRS AND MAISIITENAIYCE TO CONNEC770N A#ter the initiaf connectioa has been made to the water seroice curb stop box or tF�e sewer lead at fihe property ii�e or a wa�r senri�4ead tias been extended#a the property iine for connection,the appticarrt,owner,or occuparrt or user af such premises shali be iiabie for a!i repairs requtrad to ariy water line and sewer lirtes necessary for connection of the premises from the main to the premi�ses. 1f the property owner requests mairrtenance ser+rice or repairs be performed by the C'rty,the property owner shall be charged for the sosts of the mairrtenance and/or repairs,inciuding necessary street repairs at a rate set annuaily by an administrative policy. It shat!be the responsbilifiy o#the applicarrt, owner,occuparn or user to perform standard mairrtenance of the sewer senrice line from the premises to the main inciuding debris dearing or rocrt cutting and to maintain the water service curb stop box for operability and at such heigirt as wiU ensure#hat it remains above the finis(�ed grade of the land or property. �Ref 638,1156,],191) ,:�`� ���y �` � J ��r's.s., �r $ ,� S �,f�?r ¢:. �.:>x *4� ����3c.ti�� � ..:.3� xL:.L"9 Cit ot Fri�le Y Y Water Degartment Address ��� �y�� �� Name ���-l�C. ���� � Date ���� ' Old Meter Number � � � Old Meter Reading � ��"'v- Replacement No. � Replacement Reading � Replacement Make �. Remarks: �,�s^— ' Signed